摘要
卵圆孔未闭与偏头痛存在显著共病现象,但其因果关系及经导管封堵术的疗效仍存争议。本文系统综述了卵圆孔未闭相关偏头痛的潜在生物标志物以及相关影像学评估,旨在为卵圆孔未闭相关偏头痛的临床诊疗提供理论依据。关键生物标志物包括血小板活化标志物、降钙素基因相关肽、同型半胱氨酸及血小板/淋巴细胞比值。影像学评估涵盖右向左分流程度(经胸超声心动图、经颅多普勒超声)、脑血管屏气指数、脑白质高信号特征、静息态功能磁共振成像脑功能网络改变、光学相干断层成像检测的原位血栓以及脑电图功率谱特征。研究表明,生物标志物与影像学技术的整合可提高疾病鉴别与治疗预测的准确性。当前研究仍面临因果关系不明确、检测标准化不足等挑战,未来需多学科协作,通过多模态指标建立个体化诊疗体系,为卵圆孔相关偏头痛的精准防治提供依据。
Patent foramen ovale(PFO)demonstrates significant comorbidity with migraine,but its causal relationship and the efficacy of transcatheter closure remain controversial.This systematic review examines potential biomarkers and relevant imaging assessments for PFO-associated migraine,aiming to provide a theoretical foundation for clinical diagnosis and treatment.Key biomarkers include platelet activation markers,calcitonin gene-related peptide,homocysteine,and platelet-to-lymphocyte ratio.Imaging evaluations encompass right-to-left shunt grading(transthoracic echocardiography,transcranial Doppler ultrasound),cerebrovascular breath-holding index,characteristics of white matter hyperintensities,alterations in resting-state functional magnetic resonance imaging(rs-f-MRI)brain networks,in-situ thrombi detected by optical coherence tomography,and electroencephalogram(EEG)power spectral features.Research indicates that integrating biomarkers with imaging technologies enhances diagnostic discrimination and treatment outcome prediction.Current challenges include unclear causal relationships and insufficient standardization of detection methods.Future efforts require multidisciplinary collaboration to establish personalized diagnostic and therapeutic frameworks through multimodal indicators,thereby advancing precise prevention and treatment strategies for PFO-related migraine.
作者
刘凯园
徐吉喆
白明
王强
姚利和
LIU Kai-yuan;XU Ji-zhe;BAI Ming;WANG Qiang;YAO Li-he(The First Clinical Medical College of Lanzhou University,the First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Cardiovascular Medicine,the First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Neurology,the First Hospital of Lanzhou University,Lanzhou 730000,China)
出处
《中国介入心脏病学杂志》
2025年第9期516-522,共7页
Chinese Journal of Interventional Cardiology
