儿童偏头痛中的自主神经系统功能

Autonomic nervous system function in childhood migraine.

作者信息

Yakinci C, Mungen B, Er H, Durmaz Y, Karabiber H

机构信息

Department of Pediatrics, Inönü University Medical School, Malatya, Turkey.

出版信息

Pediatr Int. 1999 Oct;41(5):529-33. doi: 10.1046/j.1442-200x.1999.01101.x.

DOI:10.1046/j.1442-200x.1999.01101.x

PMID:10530067

Abstract

BACKGROUND

Although the pathogenesis of migraine is controversial, autonomic nervous system (ANS) dysfunction has been reported in patients with adult migraine in recent years. The present study was planned to investigate ANS function in childhood migraine.

METHODS

The migraine and control groups consisted of 25 migraineur and 30 healthy children, respectively. Orthostatic test, sustained handgrip, Valsalva ratio, 30/15 ratio and heart rate responses to deep breathing were used as non-invasive ANS function tests in both groups.

RESULTS

In the orthostatic test, systolic (SBP) and diastolic blood pressures (DBP) were higher in the upright than the supine position in the migraine group, but were higher in the supine than upright position in the control group. In the sustained handgrip test, the mean difference in SBP was higher in the migraine than the control group (P = 0.0278), but there was no significant difference in DBP between migraine and control groups (P = 0.107). The Valsalva ratio was higher in the migraine than the control group (P = 0.0002), as was the 30/15 ratio (P = 0.0108). Heart rate responses to deep breathing were not different between the migraine and control groups (P = 0.749).

CONCLUSIONS

Our results demonstrate ANS dysfunction, with hyperactivity of both the sympathetic and parasympathetic nervous system, in children with migraine.

摘要

背景

尽管偏头痛的发病机制存在争议，但近年来有报道称成人偏头痛患者存在自主神经系统（ANS）功能障碍。本研究旨在调查儿童偏头痛患者的ANS功能。

方法

偏头痛组和对照组分别由25名偏头痛患儿和30名健康儿童组成。两组均采用直立试验、持续握力试验、瓦尔萨尔瓦比率、30/15比率以及深呼吸时的心率反应作为非侵入性ANS功能测试。

结果

在直立试验中，偏头痛组直立位时的收缩压（SBP）和舒张压（DBP）高于仰卧位，而对照组仰卧位时的血压高于直立位。在持续握力试验中，偏头痛组SBP的平均差值高于对照组（P = 0.0278），但偏头痛组和对照组之间DBP无显著差异（P = 0.107）。偏头痛组的瓦尔萨尔瓦比率高于对照组（P = 0.0002），30/15比率也是如此（P = 0.0108）。偏头痛组和对照组在深呼吸时的心率反应无差异（P = 0.749）。