摘要
目的 :探讨与血管舒缩有关的神经肽以及类阿片肽在偏头痛发病中的主次作用。方法 :偏头痛患者 15 6例 ,正常对照者 82名 ,于肘静脉采取血样。SD大鼠 2 6只 ,分为预实验组 6只 ,三叉神经刺激组 10只与假手术组 10只 ,分别适时采取血样。采用放射免疫方法测定血样中的神经肽含量。结果 :与对照组相比 ,头痛间歇期患者β 内啡肽 (β EP)降低 ,而神经肽Y(NPY)升高 ;头痛缓解4天内的患者降钙素基因相关肽 (CGRP)、P物质 (SP)、血管活性肠肽 (VIP)降低 ,而强啡肽A(Dy nA)与亮啡肽 (LEK )无变化。与假手术组相比 ,三叉神经刺激大鼠血中NPY、CGRP、SP、VIP升高 ,而 β EP、LEK与DynA无变化。比较偏头痛者与大鼠三叉神经刺激后血中神经肽改变 ,唯一的不一致是偏头痛者 β EP降低。结论 :β EP的降低很可能为偏头痛发病的关键环节 ,而其余肽类含量改变则是继发现象。
Objective:To explore the status of vasoactive neuropeptides and opioid peptides during migraine attack. Methods:The blood samples were withdrawed from 156 cases of migraineurs and 82 healthy persons. Twenty six SD rats were divided into preliminary experiment group (n=6), pseudo operation group (n=10) and trigeminal stimulation group (n=10), their blood samples were withdrawed after trigeminal stimulation or pseudo operation. The plasma levels of β endorphin (β EP), neuropeptide Y (NPY), Substance P (SP), vasoactive intestinal peptide (VIP), calcitonin gene related peptide (CGRP), leu enkephalin (LEK) and dynorphin A (DynA) were determined with radioimmnuoassay method. Results: Compared with normal controls, the plasma level of β EP was significantly decreased while the level of NPY was increased in patient group during headache free period; The levels of CGRP, SP and VIP were significantly decreased in migraineurs whose headache began to remit during four days; There were no significant changes found in LEK and DynA. Compared with pseudo operation group, the levels of NPY, CGRP, SP and VIP in rats after trigeminal stimulation were significantly increased while there were no significant changes in the concentrations of β EP,LEK and DynA. Considering the possibility that the decreased levels of CGRP, SP, and VIP were induced by their massive release during migraine attack, the decreased plasma β EP level in migraineurs is the only difference between migraineurs and trigeminal stimulated rats. Conclusion: The decreased β EP level may be the key factor during migraine attacks, and the changes of the other neuropeptides may be the secondary phenomena.
出处
《中国疼痛医学杂志》
CAS
CSCD
2003年第1期3-7,共5页
Chinese Journal of Pain Medicine
基金
福建省卫生厅资助项目 (970 15 )
关键词
偏头痛
神经肽
三叉神经
Migraine
Neuropeptide
Trigeminal nerve
