卵圆孔未闭封堵术对伴卵圆孔未闭的偏头痛患者的疗效

摘要: 目的 探讨卵圆孔未闭封堵术对伴卵圆孔未闭的偏头痛患者的疗效。 方法 回顾性分析 2018－01～2018－04 我院脑血管病头痛专病门诊240 例偏头痛患者, 患者均做头部磁共振成像( magnetic resonance imaging, MＲI) + 磁共振血管成像 ( magnetic resonance angiography, MＲA) ，经胸超声心动图,TCD, TCD发泡实验。TCD发泡实验提示重度右向左分流的患者，进 一步行经食道超声心动图检查证实卵圆孔未闭，知情同意后行卵圆孔未闭封堵术。根据是否接受封堵术，分为内科治疗组和经导管卵圆孔未闭封堵术治疗组。详细记录其人口学信息、既往史、头痛的频率、头痛持续时间、头痛发作前有无先兆症状、 影像学表现、诊治经过及3 月后病程转归。 结果 240例偏头痛患者中，76例患者TCD发泡实验阳性，49例TCD发泡实验重度右向左分流， 42例经食道超声心动图证实卵圆孔未闭。内科治疗组16例，卵圆孔未闭封堵术治疗组26例。与内科治疗组相比，经导管卵圆孔未闭封堵术治疗组先兆偏头痛症状改善明显( P＜0. 05) 。 结论 卵圆孔未闭封堵术可以改善先兆偏头痛伴卵圆孔未闭患者的症状。

关键词: 偏头痛; 卵圆孔未闭; 卵圆孔未闭封堵术; 预后

Clinical efficacy of patent foramen ovale closure for the migraine patients accompanied with patent foramen ovale

FU Qiang，ZHAO Xingquan，CAO Jingbo，WANG Yongjun，WANG Yilong，LIU Gaifen，BAI Yaqiu，WANG Penglian*

Abstract: Objective To investigate the efficacy of patent foramen ovale closure for the migraine patients accompanied with patent fo

ramen ovale. Methods A total of 240 migraine patients were continuously collected in our hospital from January 2018 to April 2018． All patients underwent brain MＲI，MＲA，transthoracic echocardiogram，transcranial Doppler ultrasonography( TCD) ，contrast transcranial Doppler ultrasonography( cTCD) . Transesophageal echocardiography was performed when cTCD demonstrated the severe right to left shunt. Patients were divided into two groups: one group with patent foramen ovale closure，and another group with medical treatment. Data were recorded, including demographic information，medical history，headache attack frequency，headache duration，headache with aura，and outcomes at 3 month after the first visit．Results A total of 76 patients( 31.7%) from 240 migraine patients were found with righttoleft shunt by cTCD．Forty-nine patients were severe righttoleft shunt by cTCD．And 42 of 49 patients with severe righttoleft shunt were confirmed patent foramen ovale by transesophageal echocardiography．Sixteen patients chose the medical treatment, while 26 patients chose patent foramen ovale closure．The symptoms of migraine with aura were improved more in patients with patent foramen ovale closure than that of medical treatment( P＜0.05) ． Conclusion Patent foramen ovale closure could reduce migraine attacks with aura, accompanied with patent foramen ovale．

Key words: migraine; patent foramen ovale; patent foramen ovale closure; prognosis