屏气刺激与视觉刺激下偏头痛患者脑血管反应性对比
方玉婷 胡露宇 甘 泉 邱 涛 郑泽华
肖哲曼
武汉大学人民医院，湖北 武汉 430060
通信作者：肖哲曼
【摘要】 目的 对比屏气刺激与视觉刺激下偏头痛患者的脑血管舒缩反应性。方法 纳入2021-03—2022-03 于武汉大学人民医院就诊的偏头痛患者和正常志愿者，收集临床资料，比较 2 组在屏气刺激与视觉刺激下的脑血管反应性。结果 偏头痛组屏气指数（BHI）高于对照组（1.53±0.39 vs 1.09±0.15，P＜0.001），偏头痛组视觉刺激下平均血流速度（MFV）变化率高于对照组［（6.08±3.23）% vs（4.12±1.9）%，P＜0.05］。伴卵圆孔未闭的患者 BHI 低于不伴卵圆孔未闭患者（1.20±0.24 vs 1.64±0.26，t=-3.998，P=0.001），视觉刺激下 MFV 变化率差异无统计学意义（P＞0.05）。BHI 与年龄呈弱相关（r=0.368，P＜0.05）。结论 血管舒缩反应可反映血管的扩张潜能，且与自身调节密切相关。偏头痛患者大脑中动脉对屏气刺激与视觉刺激的血管舒张反应均高于健康人群，提示偏头痛患者脑血管自主调节能力异常。
【关键词】 偏头痛；经颅多普勒超声；脑血管反应性；屏气刺激；视觉刺激；高碳酸刺激
【中图分类号】 R747.2 【文献标识码】 A 【文章编号】 1673-5110 （2022） 07-0803-04
基金项目：国家自然科学基金（编号：81971055）
DOI：10.12083/SYSJ.220603
Comparison of cerebrovascular reactivity in migraine patients under breath holding stimulation and visual stimulation
FANG Yuting，HU Luyu，GAN Quan，QIU Tao，ZHENG Zehua，XIAO Zheman
Renmin Hospital of Wuhan University，Wuhan 430060，China
Corresponding author：XIAO Zheman
【Abstract】 Objective To compare the cerebrovascular reactivity in migraine patients under breath holding stimulation and visual stimulation.Methods Migraine patients and healthy volunteers from March 2021 to March 2022 in Renmin Hospital of Wuhan University were enrolled. The clinical data of the patients were collected and analyzed. And we compared the cerebrovascular reactivity between patients and healthy controls. Results The BHI in migraine group was higher than that in control group（1.53±0.39 vs 1.09±0.15，P＜0.001）. The change rate of MFV in migraine group under visual stimulation was higher than that in control group（（6.08±3.23）% vs （4.12±1.9）%，P＜0.05）. The BHI of migraine combined with patent foramen ovale was lower than migraine patients without patent foramen ovale（1.20±0.24 vs 1.64±0.26，t=-3.998，P=0.001）. In addition，the BHI was weakly correlated with age（r=0.368，P＜0.05）. Conclusion The vasomotor response can reflect the expansion potential of blood vessels and is closely related to self-regulation. The vasodilation response of MCA to hypercapnia stimulation and visual stimulation in patients with migraine is higher than that in healthy people. Our study suggested that the ability of cerebrovascular autonomic regulation in patients with migraine is abnormal.
【Key words】 Migraine；Transcranial Doppler；Cerebrovascular reactivity；Breath holding stimulation；Visual stimulation；Hypercapnia stimulation
