发作间隙期脑血流动力学改变对偏头痛预防性治疗效果的影响

Influence of cerebral hemodynamics changes during headache-free periods on th efficacy migraine prophylaxis

摘要:

目的 部分偏头痛发作间隙期存在脑血流动力学改变 ,但其对偏头痛治疗效果的影响尚不清楚 ,该文旨在探讨发作间隙期脑血流动力学改变与偏头痛预防性治疗效果的关系。方法 5 2例偏头痛患者在发作间隙期先进行经颅多普勒 (TCD)检查 ,分为TCD正常组与异常组 ,各组再随机给予西比灵或赛庚啶预防治疗 ,采用Bussone头痛评分评估治疗效果。结果 TCD异常患儿治疗 4个月后西比灵组头痛指数低于赛庚啶组 5 .6 9± 4 .15vs 15 .92± 10 .5 2 ,差异有显著性 (P <0 .0 5 ) ;而TCD正常的患儿治疗 4个月后赛庚啶组头痛指数低于西比灵组 6 .4 3± 6 .6 2vs 17.4 6± 11.6 2 ,差异有极显著性 (P <0 .0 1)。结论 针对发作间隙期脑血流动力学改变选用不同药物预防偏头痛 ,可能起到提高疗效、减少副反应、降低成本的作用。

Abstract:

Objective This study aims to investigate the influence of cerebral hemodynamic changes during headache-free periods on the efficacy of migraine prophylaxis. Methods Fifty-two children with migraine were given a TCD test during headache-free periods and then Normal TCD and Abnormal TCD groups were selected according to the TCD findings. Each group was randomly given either flunarizine or cyproheptadine treatment. The efficacy was evaluated with Bussone scores after 4 months of treatment. Results Bussone scores of patients treated with flunarizine were significantly lower than those of patients treated with cyproheptadine in the Abnormal TCD group ( 5.69± 4.15 vs 15.92± 10.52; P< 0.05). In the Normal TCD group, the patients treated with cyproheptadine had lower Bussone scores than those treated with flunarizine ( 6.43± 6.62 vs 17.46± 11.62; P< 0.01). Conclusions The efficacy of migraine prophylaxis may be improved by selecting rational drugs based on cerebral hemodynamics changes during headache-free periods.