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偏头痛
Migraine


Messoud Ashina ... 其他 • 2020.11.05
相关阅读
• 年轻人先兆偏头痛与隐源性缺血性卒中的关联 • 预防偏头痛的新型口服抗降钙素基因相关肽拮抗剂 • ubrogepant治疗偏头痛 • 口服降钙素基因相关肽受体拮抗剂rimegepant治疗偏头痛 • erenumab治疗发作性偏头痛的对照临床试验

偏头痛是一种普遍的神经系统疾病,估计全球约有10亿患者,其中以女性居多1。根据2016年全球疾病负担研究(Global Burden of Disease Study 2016)的数据,偏头痛是导致失能的第二大原因,其导致的失能患者数量超过其他所有神经系统疾病导致的失能患者数量总和2。偏头痛的诊断是依据《国际头痛疾病分类》第3版(International Classification of Headache Disorders, 3rd edition,ICHD-3)中的临床标准3。提示偏头痛的临床表现是持续4~72小时的中重度反复头痛发作3。如果头痛发作表现为单侧、搏动性并且体力活动后加重,则应考虑偏头痛这一诊断3。常见的伴随症状包括恶心、呕吐、畏光和畏声3。一些患者报告偏头痛发生之前有先兆,先兆的特征是可逆的神经系统局部症状,通常包括视觉或偏侧感觉障碍3

虽然偏头痛的发病机制尚未完全明确,但目前认为涉及三叉神经及其向颅内血管系统的轴突投射(称为三叉神经血管系统)4。来自三叉神经血管系统的伤害性信号传递到脑内产生偏头痛感觉的区域4。我们确定参与偏头痛发生的信号分子之后,对其发病机制有了进一步了解。进而促进了以机制为基础的偏头痛疗法的研发5。本综述介绍了目前对偏头痛发病机制的认识,这主要基于过去10年间发表的临床数据,并概述了急性偏头痛的治疗建议和偏头痛的预防性治疗建议,着重介绍近期获得批准的药物。





作者信息

Messoud Ashina, M.D., Ph.D., D.M.Sci.
From the Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen. Address reprint requests to Dr. Ashina at the Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Valdemar Hansen Vej 5, DK-2600 Glostrup, Denmark, or at ashina@dadlnet.dk.

 

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