偏头痛发作对血脑屏障的影响

背景 监测成人偏头痛患者偏头痛发作期及发作后期血清MMP-9的水平，探讨偏头痛发作对血脑屏障结构与功能的影响，进一步了解偏头痛的病理生理机制。方法 选择38例确诊的成人偏头痛患者，20例年龄、性别与之相匹配的健康对照者，在偏头痛发作期及发作后期（第1-7天）分别采静脉血5ml，健康对照者随机采采静脉血5ml，用双抗体夹心固相酶联免疫吸附试验(ELISA)法检测血清MMP-9水平。实验结果应用SAS version 9.1分析。结果 偏头痛发作期血清MMP–9(12.612±0.016 ug/L)水平要显著高于健康对照组(6.069±0.023 ug/L)， P<0.05；并会持续到发作后第6天，其中最高峰为偏头痛发作后的第3天(17.524±0.035ug/L)。偏头痛发作期，先兆偏头痛与无先兆偏头痛患者血清MMP–9水平无显著差异（P>0.05)，MMP–9水平与偏头痛发作时头痛程度无关（P>0.05)。结论 偏头痛发作可以上调血清MMP–9水平从而导致血脑屏障破坏，并持续到发作后第6天，高峰期在发作后第3天，MMP–9作为偏头痛发作的生物学标记物，对于指导偏头痛的治疗具有一定的临床意义。

Impact of migraine attacks on the blood-brain barrier

Background To determine the impact of migraine on the structure and function of the blood-brain barrier by measuring plasma matrix metalloproteinase-9(MMP-9) levels in patients at the acute and late stages of attacks in order to elucidate the pathological mechanisms involved. Methods: We recruited a case-control cohort of 38 adult migraine patients and 20 age- and gender-matched healthy control subjects. Five ml blood samples were collected at the acute and late stages of migraine (days 1-7), and also from the control subjects. Solid phase double antibody sandwich enzyme-linked immunosorbent assay (ELISA) was used to determine plasma MMP-9 levels. Statistical analysis was performed using the SAS version 9.1. Results: Initial plasma MMP-9 levels of migraine patients were significantly higher than those of controls (12.612 ± 0.016 g/L vs. 6.069 ± 0.023 g/L, respectively, P <0.05). High MMP-9 expression was observed during days 1-6 of migraine attacks, with highest expression occurring on day 3 (17.524 ± 0.035 g/L). During attacks, MMP-9 levels were similar in migraine patients with and without aura (P > 0.05); in addition, levels were not correlated with degree of headache pain (P> 0.05). Conclusions: We hypothesize that migraine could lead to increased plasma MMP-9 levels resulting in blood-brain barrier damage. MMP-9 levels increase during days 1-6 of migraine attacks, peaking on day 3. Therefore, MMP-9 could be used as a biological marker to guide treatment of migraine attacks.