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Title:: Correlation analysis on the headache accompanied by atrial septal defect occlusion and morphometric characteristics of occluder

作者:: 王星烨; 成革胜; 杜亚娟; 张玉顺; (西安交通大学第一附属医院心内二科，陕西西安 710061)

Author(s):: WANG Xingye; CHENG Gesheng; Du Yajuan; ZHANG Yushun; (Second Department of Cardiology, First Affiliated Hospital, Medical College of Xi’an Jiao tong University, Xi’an 710061, Shaanxi, China)

关键词:: 房间隔缺损; 封堵器; 头痛

Keywords:: atrial septal defect; occluder; headache

分类号:: R541

DOI:: -

文献标识码:: A

摘要:: 目的:研究房间隔缺损封堵术后头痛与封堵器形态之间的关系，以此探讨术后头痛的原因和机制。方法:继发孔型房间隔缺损患者183（男66，女117）例，年龄6～72（30.1±1.5）岁。经胸心动超声(Transthoracic Echocardiography，TTE)测量房间隔缺损最大直径为8～35(19.8±7.5) mm，选用的封堵器大小为10～44(25.9±8.9) mm。结果:术后3个月新出现头痛症状患者为16例，发生率为8.7%。头痛组房间隔缺损（Atrial Septal Defect，ASD）缺损大小为(27.3±6.2) mm，无头痛组为(17.1±7.2) mm，头痛组缺损明显大于无头痛组（P<0.01）。头痛组封堵器直径、超声测量封堵器的厚度均较无头痛组大（均P<001）。封堵器直径与缺损大小的差值和封堵器直径与术后封堵器直径的差值头痛组亦明显大于无头痛组（P<005或P<001）。多因素相关分析显示，头痛与封堵器厚度显著相关（P<0.01），而与年龄、缺损大小、封堵器直径等不相关。结论:L封堵器厚度越厚，头痛症状发生率越高。头痛可能与封堵器表面内皮化不全或内皮化进程延长有关。

Abstract:: AIM:This study investigated the causes and mechanism accounting for the headache symptom observed after atrial septal defect (ASD) occlusion, by studying the correlation between the headache symptom and the geometrical characteristics of the occluder. METHODS: 183 patients (66 male, 117 female) with secundum atrial septal defect were included at the age of 6 to 72 (3011±1848) years. The maximum size of defect was in the range of 8-35 35(198±74) mm, measured by transthoracic echocardiography (TTE). Theoccluders used are in the size range of 10-44(259±89) mm. RESULTS: 16 patients (87% of all patients) reported a postoperative headache in 3 months. The headacheaccompanying group had significantly greater ASD defect sizes (273±62) mm compared to the defect sizes in the nonheadache group ［(171±72) mm, P<001］. In the headacheaccompanying group, both the diameter and thickness (measured by ultrasonic measurement) of the occluder were significantly larger than those used in the nondiscomforting group (P<001). The difference between the occluder diameter and the defect size, as well as the difference between the original and postoperative diameters of the occluder, were significantly larger in the headacheaccompanying group, compared to the nondiscomforting group (P<005 and P<001, respectively). The correlation analysis demonstrated that the incidence rate of a headache was significantly related to the thickness of the occluder (P<001), however independent of age, defect size, occluder diameter, and other morphometric indicators. CONCLUSION: The higher incidence rate of a headache after the ASD occlusion positively correlates with the thickness of the occluder. We speculate that the headache may be caused by the incomplete endothelialization of the occluder device surface or prolonged endothlialization process.

参考文献/References

[1]张玉顺,李寰,代政学,等.成人房间隔缺损介入治疗进展[J].心脏学杂志,2003,15(1):73-75.
[2]李舜伟,李焰生,刘若卓,等.中国偏头痛诊断治疗指南[J].中国疼痛医学杂志,2011,17(2):65-86.
[3]张玉顺,贾国良,何争,等.应用Amplatzer封堵器治疗房间隔缺损[J].心脏杂志,2000,12(5):379-381.
[4]张玉顺,贾国良,刘建平,等.应用Amplatzer封堵器治疗房间隔缺损疗效评价[J].心脏杂志,2001,13(6): 476-478.
[5]竹岛多贺夫,徐万鹏,陈琼,等.偏头痛的诊断和分类标准[J].日本医学介绍,2007,28(1):4-8.
[6]张玉顺,代政学,张军,等.经胸超声心动图监视下应用Amplatzer封堵器治疗房间隔缺损[J].心脏杂志, 2001,13(5):393-395.
[7]李寰,张玉顺,代政学,等.Amplatzer房间隔封堵器治疗200例的并发症[J].心脏杂志,2003,15(6):549-551.
[8]戴汝平,刘延玲,张戈军,等.应用Amplatzer封堵器介入治疗房间隔缺损疗效评价(附60例报告)[J].中华心血管病杂志,2000,28(5):371-375.
[9]Wertman B,Azarbal B,Riedl M,et al.Adverse events associated with nickel allergy in patients undergoing percutaneous atrial septal defect or patent foramen ovale closure[J].J Am Coll Cardiol,2006,47(6):1226-1227.
[10]RodésCabau J,Mineau S,Marrero A,et al.Incidence,timing,and predictive factors of newonset migraine headache attact after transscatheter closureo of atrial septal defect or patent foramen ovale[J].Am J Cardiol,2008,101(5):688-692.
[11]Sharafuddin MJ,Gu X,Titus JL,et al. Transvenous closure of secundum atrial septal defects: preliminary results with a new selfexpanding nitinol prosthesis in a swine model[J].Cirulation,1997,95(8):2162-8.[12]陈名武,周爱卿,李奋,等.国产房间隔缺损堵塞装置内皮化的实验研究[J].介入放射学杂志,2003,12(5):365-368.
[13]万陈,成革胜,张婷婷,等.房间隔缺损封堵术后内皮化不全的实验研究[J].心脏杂志,2013,25(3):270-273.

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房间隔缺损封堵术后头痛与封堵器形态相关分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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