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加巴喷丁对偏头痛患者血流动力学状态及PKC水平的影响

作者:王洪亮

所属单位:洛阳东方医院神经内科(河南 洛阳 471003)

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摘要

目的 观察加巴喷丁(GBP)对偏头痛患者血流动力学状态及蛋白激酶C(PKC)水平的影响研究。方法 将78例偏头痛患 者按随机数字表法分为GBP组(研究组,n=39)和氟桂利嗪组(对照组,n=39)。于治疗前(T1)及治疗1个月后(T2)时检 测左(L)右(R)两侧大脑前动脉(ACA)、中动脉(MCA)及后动脉(PCA)平均血流速度(Vm),检测2组患者血浆PKC水平, 评估头痛程度[简化McGill疼痛问卷-2(SF-MPQ-2)]。结果 T2时,2组上述血管LACA、RACA、LMCA、RMCA、LPCA、 RPCA的Vm、血浆PKC水平和SF-MPQ-2评分均较T1时降低,且研究组低于对照组(P<0.05)。结论 加巴喷丁对改善偏 头痛患者血流动力学状态,抑制中枢敏感化有一定帮助,可有效缓解疼痛,于患者病情转归有利。

Objective To observe the effect of Gabapentin (GBP) on hemodynamic status and protein kinase C (PKC) levels in patients with migraine. Methods 78 migraine patients were randomly divided into GBP group (study group, n=39) and flunarizine group (control group, n=39). The mean velocities (Vm) of left (L) and right (R) anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) in the two groups were detected before treatment(T1) and 1 month after treatment(T2), the plasma PKC levels in the two groups were tested, and the degrees of headache [Short-form McGill Pain Questionnaire-2 (SF-MPQ-2)] in the two groups were also assessed. Results At the time of T2, the levels of Vm and plasma PKC, and SF-MPQ-2 scores of LACA, RACA, LMCA, RMCA, LPCA and RPCA in the two groups were all lower than those at T1, and the change ranges in the study group were lower than those in the control group (P<0.05). Conclusion Gabapentin which is beneficial to the prognosis of patients, can improve hemodynamic status, inhibit central sensitization, and effectively relieve pain of migraine patients.

【关键词】加巴喷丁;偏头痛;血流动力学状态;蛋白激酶C

【中图分类号】R972+.6;R747.2

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2019.01.002

前言

文献显示,我国偏头痛年发病率约为 4.2%~14.6%,女性发病率约为男性的3倍[1]。该疾病 常引起精神障碍、焦虑、疲劳、食欲不振、全身不适 等情况,严重影响患者身体健康和生活质量。目前临 床采用加巴喷丁(GBP)等改善神经病理性疼痛药物治 疗偏头痛取得了一定疗效。相关研究认为,该疾病可 能与颅内血管舒缩功能障碍、中枢敏感化等因素有 关[2]。而蛋白激酶C(PKC)参与偏头痛中枢敏感化的形 成[3]。对此,本研究观察GBP对偏头痛患者血流动力 学状态及PKC水平的影响,探讨GBP治疗偏头痛的作 用机制,为GBP治疗偏头痛奠定理论基础,现报告如 下。