Glyceryl trinitrate induced headache in migraineurs - relation to attack frequency
Glyceryl trinitrate induced headache in migraineurs - relation to attack frequency
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DOI：
10.1046/j.1468-1331.2000.00094.x
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发表时间：
2000-07-01
影响因子：
5.1
通讯作者：
Olesen, J
中科院分区：
文献类型：
--
作者：
Christiansen, I;Daugaard, D;Olesen, J
甘油三硝酸酯，一氧化氮的前药，在健康受试者中诱导轻度至中度头痛，而偏头痛患者发展为更严重的头痛，类似于自发性偏头痛发作。为了研究这种增加的一氧化氮敏感性是否取决于自发性偏头痛发作的频率，对15名患有罕见的无先兆偏头痛发作（小于或等于4次发作/年）的偏头痛患者静脉输注硝酸甘油酯（0.5 μ g/kg/min）。14名年龄匹配的无先兆偏头痛频繁发作（大于或等于12次发作/年）的偏头痛患者和14名健康受试者作为对照。偏头痛组之间的任何几个参数都没有显着差异，尽管在频繁的偏头痛患者中总是倾向于更多的头痛。与健康受试者相比，频繁和罕见发作的偏头痛患者的头痛明显更严重，持续时间更长，并且更频繁地满足无先兆偏头痛的诊断标准（P = 0.0001）。总之，偏头痛患者对硝酸甘油的超敏感性似乎与一种基本的-可能是遗传决定的-涉及一氧化氮的病理生理机制有关，而与环境影响无关，这在很大程度上决定了偏头痛的表达。
Glyceryl trinitrate, a prodrug of nitric oxide, induces a mild to moderate headache in healthy subjects, whilst migraineurs develop a more severe headache, resembling spontaneous migraine attacks. In order to investigate whether this increased nitric oxide sensitivity depends upon the frequency of spontaneously occurring migraine attacks, intravenous infusion of glyceryl trinitrate (0.5 mu g/kg/min) was given to 15 migraine patients with rare attacks (less than or equal to 4 attacks/year) of migraine without aura. Fourteen age-matched migraine patients with frequent attacks of migraine without aura (greater than or equal to 12 attacks/year) and 14 healthy subjects served as controls. No significant difference between the migraine groups for any of several parameters was detected, although the trend was always towards more headaches in frequent migraineurs. Both migraineurs with frequent and rare attacks experienced a headache that was significantly more severe, longer lasting, and fulfilled the diagnostic criteria for migraine without aura more often, compared to the healthy subjects (P = 0.0001). Conclusively, supersensitivity to glyceryl trinitrate in migraineurs seems to be related to a basic - probably genetically determined - pathophysiological mechanism involving nitric oxide, and not to the environmental influences, which to a large extent determine the: expression of migraine.