Parrinello G, Paterna S, Di Pasquale P, Pinto A, Cardinale A, Maniscalchi T, Cottone C, Follone G, Tuttolomondo A, Bologna P, Colomba D, D'Angelo A, Ortoleva A, Garofalo L, Piovana G, Capodieci E, Bova A, Giubilato A, Licata G
Department of Internal Medicine, University of Palermo, Italy.
Drugs Exp Clin Res. 1998;24(4):197-205.
Sumatriptan, a selective 5-hydroxy-triptamine (5-HT1) receptor agonist, has been used recently in the treatment of acute migraine. Some in vitro experiments suggested that sumatriptan has vasoactive properties in vascular beds distinct from cerebral circulation. In view of this we investigated the vascular effects of the standard 6 mg subcutaneous (s.c.) dose of sumatriptan, on the surface areas of the head using thermography, a simple and reliable method for detecting temperature changes. The head temperature of 127 patients (double-blind), 102 migraines (52 during headache attack and 50 headache-free) and 25 healthy control subjects were evaluated using thermography in basal condition and 30, 60, 90, and 120 min after s.c. sumatriptan injection of placebo. During the entire observation period systemic blood pressure (SBP), heart rate (HR) and continuous electrocardiogram (ECG) were detected automatically. A significant head temperature decrease was observed after s.c. sumatriptan administration, in both healthy controls and migraine subjects; placebo administration did not show any change of temperature. In migraine patients during headache attack, head temperature reduction corresponded to the relief of headache symptoms. This vasoconstrictor effect detected with thermography is not isolated to cranial circulation but it is also systemic. In fact, we observed a significant increase (p < 0.05) in both systolic and diastolic systemic blood pressure. No significant changes in heart rate and ECG abnormalities were otherwise detected. These findings suggest that sumatriptan is effective in the treatment of migraine attack, but it must be used with caution in migraines with concomitant hypertension.
舒马曲坦是一种选择性5-羟色胺（5-HT1）受体激动剂，最近已被用于治疗急性偏头痛。一些体外实验表明，舒马曲坦在与脑循环不同的血管床中具有血管活性特性。鉴于此，我们使用热成像技术（一种检测温度变化的简单可靠方法）研究了标准6毫克皮下注射剂量的舒马曲坦对头部表面积的血管影响。在基础状态以及皮下注射舒马曲坦或安慰剂后的30、60、90和120分钟，使用热成像技术评估了127例患者（双盲）、102例偏头痛患者（52例在头痛发作期间，50例无头痛）和25名健康对照者的头部温度。在整个观察期内，自动检测全身血压（SBP）、心率（HR）和连续心电图（ECG）。皮下注射舒马曲坦后，在健康对照者和偏头痛患者中均观察到头部温度显著下降；注射安慰剂未显示温度有任何变化。在头痛发作期间的偏头痛患者中，头部温度降低与头痛症状的缓解相对应。通过热成像检测到的这种血管收缩作用并非仅限于颅循环，而是全身性的。事实上，我们观察到收缩压和舒张压均显著升高（p < 0.05）。未检测到心率和心电图异常有显著变化。这些发现表明，舒马曲坦在治疗偏头痛发作方面有效，但在伴有高血压的偏头痛患者中必须谨慎使用。
