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目的 观察儿童偏头痛时经颅多普勒脑血流特征 ,了解其对儿童偏头痛的诊断价值。方法 采用经颅多普勒对 182例儿童偏头痛发作期及间歇期脑血流动力学进行监测 ,同时与 91例正常儿童的结果进行对照分析。结果 头痛发作时脑血流动力学异常率较高 ,典型偏头痛为 85 .7% ,普通偏头痛为 83.6 %。脑血管痉挛频谱的分别为 73.8%及 75 % ,前者单根血管痉挛发生率为 5 4.8% ,后者为 10 .7% (P <0 .0 1)。两侧血流不对称率分别为 47.6 %及 8.6 % (P <0 .0 1)。间歇期脑血流动力学均恢复正常。以脑血管痉挛频谱为诊断条件的诊断价值分析 :阳性预测值 (+pv)、阴性预测值 (- pv)、阳性拟然比 (LR+ )、阴性拟然比 (LR-)分别为 81.6 %对 93.7% ,88.4%对 70 .6 % ,9.97对 10 .14及 0 .2 8对 0 .2 7。结论 儿童偏头痛的经颅多普勒频谱表现 ,发作期以脑血管痉挛为主 ,典型偏头痛以单根非对称性改变为主 ,普通偏头痛以多根对称性为主。经颅多普勒可作为儿童偏头痛检查的重要手段。
Objective To observe the characteristics of transcranial Doppler cerebral blood flow in children with migraine and to find out its diagnostic value in children with migraine. Methods Transcranial Doppler was used to monitor the cerebral hemodynamics in the onset and intermission of migraine in 182 children. The results were compared with the results of 91 normal children. Results The abnormal rate of cerebral hemodynamics was high at the onset of headache, with a typical migraine of 85.7% and a common migraine of 83.6%. The spectrum of cerebral vasospasm was 73.8% and 75% respectively. The former had a single vasospasm of 4.8% and the latter 10.7% (P <0.01). The asymmetry of blood flow on both sides was 47.6% and 8.6%, respectively (P <0.01). Intermittent cerebral hemodynamics returned to normal. The diagnostic value of the spectrum of cerebral vasospasm as diagnostic criteria: positive predictive value (+ pv), negative predictive value (- pv), positive likelihood ratio (LR +), and negative predictive value (LR-) were 81.6% 93.7%, 88.4% vs 70.6%, 9.97 vs 10.14 and 0.8 2 vs 0.27. Conclusions The transcranial Doppler spectrum of migraine in children shows cerebral vasospasm during the attack. The typical migraine is mainly single asymmetry, and the common migraine is dominated by multiple symmetries. Transcranial Doppler can be used as an important measure of migraine in children.