[1]郭 伟,王 婧,郭俊晓,等.卵圆孔未闭形态学参数和血液指标对封堵术后偏头痛疗效预测[J].介入放射学杂志,2026,(03):266-270.[doi:10.3969/j.issn.1008-794X.2026.03.005 ]
　GUO Wei,WANG Jing,GUO Junxiao,et al.Morphological parameters and hematological indicators as predictive markers for migraine improvement following patent foramen ovale closure[J].J Intervent Med,2026,(03):266-270.[doi:10.3969/j.issn.1008-794X.2026.03.005 ]
点击复制

卵圆孔未闭形态学参数和血液指标对封堵术后偏头痛疗效预测()

PDF下载中关闭

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2026年03
页码:
266-270
栏目:
心脏介入
出版日期:
2026-03-25

文章信息/Info

Title:
Morphological parameters and hematological indicators as predictive markers for migraine improvement following patent foramen ovale closure
文章编号:
1008-794X(2026)-003-0266-05
作者:
郭 伟;  王 婧;  郭俊晓;  赵红燕
010050 内蒙古呼和浩特 内蒙古医科大学附属医院心脏大血管外科(郭 伟、郭俊晓),超声医学科(王 婧、赵红燕)
Author(s):
GUO Wei; WANG Jing; GUO Junxiao; ZHAO Hongyan.
Department of Cardiovascular Surgery,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia Autonomous Region 010050,China.
关键词:
卵圆孔未闭;  偏头痛;  超声检查;  血液指标
分类号:
R541.1
DOI:
10.3969/j.issn.1008-794X.2026.03.005
文献标志码:
A
摘要:
目的 探讨卵圆孔未闭(PFO)形态学特征与右向左分流(RLS)关联性,分析实验室指标因素对封堵术治疗偏头痛疗效的影响。方法 回顾性纳入47例因先兆性偏头痛接受PFO封堵术患者,通过经食管超声心动图(TEE)评估PFO形态,结合对比经胸超声心动图(cTTE)(右心声学造影)检查和对比增强经颅多普勒超声(cTCD)(发泡试验)评估量化RLS状态,检测术前及术后D-二聚体(D-D)、血小板计数(PLT)、血小板平均体积(MPV),并在连续随访12个月时评估患者偏头痛症状缓解情况。结果 47例患者中37例(78.7%)偏头痛症状完全缓解,头痛影响测评量表(HIT)-6评分、月均头痛发作次数及头痛发作平均时长与术前对比明显下降,差异有统计学意义(均P<0.001); 未缓解患者中3例仍存少量RLS。PFO形态与RLS状态相关性研究中复杂型PFO倾向于固有型RLS(P<0.05),PFO隧道形态与RLS程度剂量分析显示隧道宽度变化量大更易导致大量分流(P<0.05)。患者年龄与RLS程度对比差异有统计学意义(P<0.001)。缓解组术后PLT、MPV明显下降,对比未缓解组差异有统计学意义(均P<0.05); 术后D-D对比未缓解组差异无统计学意义(P=0.370)。Logistic回归分析结果显示,年龄<50岁(OR=4.21,95%CI=1.89～9.32)、中-大量RLS(OR=3.75,95%CI=1.62～8.67)、术后PLT下降(OR=0.42,95%CI=0.21～0.85)、术后MPV下降(OR=0.38,95%CI=0.18～0.79)是PFO封堵术后偏头痛症状缓解的独立预测因素。结论 复杂型PFO更倾向于存在固有型RLS,隧道宽度变化量大更易导致大量RLS。术后PLT、术后MPV降低会缓解封堵术后偏头痛发生。年龄<50岁、存在中-大量RLS的先兆性偏头痛患者更适合PFO封堵手术。

参考文献/References:

[1] Kumar P,Kijima Y,West BH,et al.The connection between patent foramen ovale and migraine[J].Neuroimaging Clin N Am,2019,29:261-270.
[2]Mac Grory B,Ohman EM,Feng W,et al.Advances in the management of cardioembolic stroke associated with patent foramen ovale[J].BMJ,2022,376:e063161.
[3]赵恩法,谢 航,张玉顺.卵圆孔未闭偏头痛患者封堵术后偏头痛完全缓解影响因素分析[J].中华心血管病杂志,2023,51:656-661.
Zhao EF,Xie H,Zhang YS.Identification of potential influencing factors associated with elimination of migraine headache in patients with PFO after percutaneous closure[J].Chin J Cardiol,2023,51:656-661.
[4]Yucel Y,Tanriverdi H,Arkanoglu A,et al.Increased fibrinogen,D-dimer and galectin-3 levels in patients with migraine[J].Neurol Sci,2014,35:545-549.
[5]余东彪,马礼坤,胡 昊,等.冲击波球囊在急性ST段抬高型心肌梗死合并血栓负荷患者急性支架膨胀不全应用1例[J].中国介入心脏病学杂志,2025,33:54-57.
Yu DB,Ma LK,Hu H,et al.Under-expanded stent of acute ST-segment elevation myocardial infarction with coronary thrombosis using intravascular lithotripsy:a case report[J].Chin J Intervent Cardiol,2025,33:54-57.
[6]王裕星,杨 松,于 铭,等.TAVR对重度主动脉瓣狭窄患者心电重构的改善作用[J].中华心血管病杂志,2025,53:56-60.
Wang YX,Yang S,Yu M,et al.The improvement effects of TAVR on cardiac electrical remodeling of patients with severe aortic stenosis[J].Chin J Cardiol,2025,53:56-60.
[7]司 婷.多区域脑机接口闭环刺激对啮齿动物具有镇痛作用[J].中国疼痛医学杂志,2025,31:161-163.
Si T.Closed-loop stimulation using a multiregion brain-machine interface has analgesic effects in rodents[J].Chin J Pain Med,2025,31:161-163.
[8]杨 璐,周 慧,沈 文,等.先天性卵圆孔未闭相关缺血性卒中患者血清生化及全血细胞计数临床研究[J].中国介入心脏病学杂志,2022,30:770-774.
Yang L,Zhou H,Shen W,et al.Biochemical parameters and blood count findings in ischemic stroke associated with patent foramenovale[J].Chin J Intervent Cardiol,2022,30:770-774.
[9]Pristipino C,Sievert H,D'Ascenzo F,et al.European position paper on the management of patients with patent foramen ovale.General approach and left circulation thromboembolism[J].Eur Heart J,2019,40:3182-3195.
[10]Caputi L,Usai S,Carriero MR,et al.Microembolic air load during contrast-transcranial Doppler:a trigger for migraine with aura?[J].Headache,2010,50:1320-1327.
[12]李天虚,焦伯延,闫西鹏.卵圆孔未闭封堵后残余分流发生的相关因素及与偏头痛缓解程度的关系[J].介入放射学杂志,2025,34:28-32.
Li TX,Jiao BY,Yan XP.Factors associated with residual shunt occurring after closure surgery of patent foramenovale and its relationship with the relief degree of migraine[J].J Intervent Radiol,2025,34:28-32.
[13]Delabays C,Correia P,Eeckhout E,et al.Comparison of atrial septal defect and patent foramen ovale in cryptogenic strokes[J].J Stroke Cerebrovasc Dis,2024,33:107664.
[14]徐若愚,王家琛,林玥彤,等.1990～2019年中国偏头痛发病趋势及其年龄-时期-队列分析[J].中国循证医学杂志,2024,24:658-665.
Xu RY,Wang JC,Lin YT,et al.Trends in migraine incidence and age-period-cohort analysis in China from 1990 to 2019[J].Chin J Evid-based Med,2024,24:658-665.
(收稿日期:2025-02-11)
(本文编辑:谷 珂)

相似文献/References:

[1]郑庆厚,朱鲜阳.卵圆孔未闭的诊断与治疗[J].介入放射学杂志,2008,(07):527.
　ZHENG Qinghou,ZHU Xianyang.Diagnosis and treatment of patent foramen ovale[J].J Intervent Med,2008,(03):527.
[2]孟庆涛,刘继红,池程伟,等.经食道心脏超声在卵圆孔未闭封堵术前检查的应用比较[J].介入放射学杂志,2026,(04):445.[doi:10.3969/j.issn.1008-794X.2026.04.018 ]
　MENG Qingtao,LIU Jihong,CHI Chengwei,et al.Application of transesophageal echocardiography in preoperative examination of patent foramen ovale closure surgery[J].J Intervent Med,2026,(03):445.[doi:10.3969/j.issn.1008-794X.2026.04.018 ]

备注/Memo

备注/Memo:
基金项目: 内蒙古医科大学联合项目(YKD2023LH034)
通信作者: 王 婧 E-mail:2631368484@qq.com
更新日期/Last Update: 2026-03-25