偏头痛患者的脑电图指标：系统评价与荟萃分析。
Electrographic indices in migraine patients: A systematic review and meta-analysis.
作者信息
Lee Sharen, Gong Mengqi, Lai Rachel W C, Liu Fang Zhou, Lam Michael Huen Sum, Chang Dong, Xia Yunlong, Liu Tong, Tse Gary, Li Ka Hou Christien
机构信息
Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong S.A.R., P.R. China.
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China.
出版信息
J Electrocardiol. 2019 Nov-Dec;57:63-68. doi: 10.1016/j.jelectrocard.2019.05.018. Epub 2019 Jun 1.
BACKGROUND AND AIM
Migraine patients can exhibit autonomic dysregulation, in turn leading to cardiac conduction and repolarization abnormalities. This systematic review and meta-analysis evaluated the electrocardiographic changes in migraineurs.
METHOD
PubMed and Embase databases were searched for human studies using the search terms 'migraine' and 'electrocardiogram' until 15th December 2018, identifying 108 and 131 studies.
RESULTS
Thirteen studies involving 667 migraineurs and 208 normal subjects included (mean age=30.7, total male percentage=19.8%) were included. A longer mean QTc interval (standard mean difference=7.89, 95% confidence interval=[3.29, 12.49], p=0.0008) and higher frequency of QTc prolongation (risk ratio [RR]=6.23, [2.86-13.58], p<0.00001), but no difference in PR-interval (SMD=4.33, [-3.90-12.56], p=0.30) were observed during migraine attacks compared to pain-free periods. P-wave dispersion was higher in migraine patients compared to controls (mean difference=3.62, [1.03-6.21], p=0.006). RR-interval were statistically indistinguishable between migraine patients and controls (SMD=0.08, [-0.65-0.81], p=0.83), or between migraineurs with and without aura (SMD=-0.03, [-0.44-0.38], p=0.89). Deep breathing ratio was significantly lower in migraineurs compared to controls (SMD=-0.27, 95% CI=[-0.46, -0.08], p=0.006) but similar between migraineurs with and without aura (SMD=-0.04, [-0.27-0.19], p=0.74). No significant difference in Valsalva ratio is found between migraineurs and controls (SMD=0.10, [-0.32-0.53], p=0.63) or between migraineurs with and without aura (SMD=-0.17, [-0.40-0.06], p=0.14). Root mean square of successive differences (RMSSD) (SMD=-0.07, [-1.10-0.95], p=0.89) and standard deviation of NN intervals (SDNN) (SMD=-0.10, [-0.61-0.41], p=0.71) did not significantly differ between migraine patients and controls.
CONCLUSION
Electrocardiographic alterations are observed in migraine patients compared to controls, especially during migraine attacks.
背景与目的
偏头痛患者可出现自主神经调节功能紊乱，进而导致心脏传导和复极异常。本系统评价和荟萃分析评估了偏头痛患者的心电图变化。
方法
检索PubMed和Embase数据库中截至2018年12月15日使用“偏头痛”和“心电图”检索词的人体研究，分别识别出108项和131项研究。
结果
纳入了13项研究，共667例偏头痛患者和208例正常受试者（平均年龄=30.7岁，男性总比例=19.8%）。与无痛期相比，偏头痛发作期间平均QTc间期更长（标准平均差=7.89，95%置信区间=[3.29, 12.49]，p=0.0008），QTc延长频率更高（风险比[RR]=6.23，[2.86 - 13.58]，p<0.00001），但PR间期无差异（标准平均差=4.33，[-3.90 - 12.56]，p=0.30）。与对照组相比，偏头痛患者的P波离散度更高（平均差=3.62，[1.03 - 6.21]，p=0.006）。偏头痛患者与对照组之间的RR间期无统计学差异（标准平均差=0.08，[-0.65 - 0.81]，p=0.83），有先兆和无先兆偏头痛患者之间也无差异（标准平均差=-0.03，[-0.44 - 0.38]，p=0.89）。与对照组相比，偏头痛患者的深呼吸比率显著降低（标准平均差=-0.27，95%置信区间=[-0.46, -0.08]，p=0.006），但有先兆和无先兆偏头痛患者之间相似（标准平均差=-0.04，[-0.27 - 0.19]，p=0.74）。偏头痛患者与对照组之间的乏氏比值无显著差异（标准平均差=0.10，[-0.32 - 0.53]，p=0.63），有先兆和无先兆偏头痛患者之间也无差异（标准平均差=-0.17，[-0.40 - 0.06]，p=0.14）。偏头痛患者与对照组之间的逐搏RR间期差值的均方根（RMSSD）（标准平均差=-0.07，[-1.10 - 0.95]，p=0.89）和NN间期标准差（SDNN）（标准平均差=-0.10，[-0.61 - 0.41]，p=0.71）无显著差异。
结论
与对照组相比，偏头痛患者存在心电图改变，尤其是在偏头痛发作期间。
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