尼麦角林对偏头痛患者脑血流动力学与血浆5-羟色胺的影响

目的探讨尼麦角林对偏头痛患者脑血流动力学与血浆5-羟色胺(5-HT)水平的影响。方法选择67例偏头痛患者随机分为尼麦角林治疗组(35例)和对照组(32例),同时选择30例健康体检者为健康对照组,治疗组应用尼麦角林治疗,对照组应用双氯芬酸钠治疗,应用经颅多普勒超声(TCD)技术检测治疗组和对照组治疗前后及健康对照组双侧大脑中动脉、大脑前动脉、椎动脉和基底动脉的(mean velocity,Vm)变化。采用高效液相色谱紫外光法测定3组血浆5-HT浓度,比较3组颅内动脉血流动力学的改变与血浆5-HT水平。结果 67例服药前大脑前动脉、大脑中动脉、椎动脉和基底动脉的平均血流速度与健康对照组比较增快。治疗后对照组变化不明显,治疗组大脑前动脉、大脑中动脉、椎动脉和基底动脉的平均血流速度降低,且与健康对照组比较差异无统计学意义(P0.05)。与健康对照组比较,偏头痛患者(治疗组和对照组)发作期血浆5-HT水平降低,发作间期血浆5-HT水平升高,差异有统计学意义(P0.05)。治疗后治疗组血浆5-HT水平发作期较治疗前和对照组显著升高,发作间期较治疗前和对照组明显下降(P0.05)。结论尼麦角林可明显预防和减轻偏头痛患者的发作,改善偏头痛患者的脑血流,调节偏头痛患者发作期和发作间期的血浆5-HT水平可能是其作用机制之一。

Effect of nicergoline on cerebral blood flow and plasmatic 5-HT in patients with migraine

Objective To observe the effect of nicergoline on cerebral blood flow and plasmatic 5-HT in patients with mi-graine.Methods Totally 67 patients with migraine were randomly divided into trial group (35 patients)and control group (32 patients),and 30 health volunteers were selected as health control group.The patients in trial group were treated with nicergoline, while the patients in control group were treated with diclofenac sodium.The mean velocity (Vm)of the middle cerebral artery,an-terior cerebral artery,posterior cerebral artery,vertebral artery and basilar artery were examined by transcranium Doppler before and after treatment.The plasmatic 5-hydroxytryptamine (5-HT)was determined by high-performance liquid chromatography with ultraviolet detection.Results Before treatment,the Vm of anterior cerebral artery,middle cerebral artery,vertebral artery,basilar artery in 67 patients was significantly different from health controls,while no marked difference was found between trial group and control group.After treatment,the Vm of patients in trail group was remarkably different from that of pretreatment,while no sig-nificant difference was displayed in control group compared to pretreatment.Before treatment,the plasmatic 5-HT of patients in trial group and control group was significantly different from health control group,but no obviously difference was found between trial group and control group.After treatment,the plasmatic 5-HT of patients in the attack stage was markedly increased and that of patients in the interval of migraine was distinctly decreased in trial group,while no significant difference was displayed in control group compared to pretreatment.Conclusion Nicergolin can markedly improve the cerebral blood flow of patients with migraine, and to adjust plasmatic 5-HT may be one of the mechanisms which nicergolin implements to do that.