Harer C, von Kummer R
Department of Neurosonology, Bowman Gray School of Medicine, Winston-Salem, North Carolina.
J Neurol. 1991 Feb;238(1):23-6. doi: 10.1007/BF00319705.
Cerebrovascular reactivity to CO2 inhalation was studied by transcranial Doppler sonography in 30 patients with classic or common migraine and 39 healthy controls without clinical or ultrasonic signs of arteriosclerosis. Systolic and diastolic Doppler frequencies of the middle cerebral artery were plotted against end-tidal CO2 partial pressure; the reactivity index (I x R) was defined as relative frequency change during a PCO2 increase of 5 mmHg. In the normal subjects, I x R was 20.0 +/- 6.3 for systolic velocities, and 26.0 +/- 8.2 for diastolic values. Migraineurs during their headache-free interval had significantly higher I x R values on the affected side (mean: 41.6 systolic, 61.2 diastolic), compared with either controls (P less than 0.01) or the contralateral side (mean: 28.3 systolic, 30.8 diastolic; P less than 0.01). During the headache attack, CO2 reactivity was significantly lower than normal only for systolic velocities (mean: 8.3; P less than 0.05). Increased CO2 reactivity is thought to be one phenomenon of migraine. Transcranial Doppler CO2 testing of cerebrovascular reactivity is a reliable method that may be of interest for the diagnostic evaluation and management of migraine patients.
采用经颅多普勒超声检查法，对30例典型或普通偏头痛患者以及39名无临床或超声动脉硬化迹象的健康对照者进行了吸入二氧化碳时脑血管反应性的研究。将大脑中动脉的收缩期和舒张期多普勒频率与呼气末二氧化碳分压作图；反应性指数（I×R）定义为二氧化碳分压增加5 mmHg期间的相对频率变化。在正常受试者中，收缩期速度的I×R为20.0±6.3，舒张期值为26.0±8.2。与对照组（P＜0.01）或对侧（收缩期平均值：28.3，舒张期平均值：30.8；P＜0.01）相比，偏头痛患者在无头痛间期患侧的I×R值显著更高（收缩期平均值：41.6，舒张期平均值：61.2）。在头痛发作期间，仅收缩期速度的二氧化碳反应性显著低于正常水平（平均值：8.3；P＜0.05）。二氧化碳反应性增加被认为是偏头痛的一种现象。经颅多普勒二氧化碳脑血管反应性检测是一种可靠的方法，可能对偏头痛患者的诊断评估和管理有意义。
