摘要
偏头痛(migraine)是一种临床常见的慢性疾病,主要表现为可引起失能的发作性头痛,且可伴先兆症状等其他症状。病因相对不明确,目前已发现4个少见的相关基因。偏头痛的发病机制可能与扩散去极化有关,去极化引起先兆症状并启动三叉神经疼痛通路的激活,最终引发头痛。血管收缩可能只是一种继发现象。偏头痛的治疗根据发病严重程度不同而有所区别。降钙素基因相关肽受体拮抗剂和选择性5-羟色胺1F受体激动剂有望成为有效的急性期治疗药物。针对降钙素基因相关肽通路的单抗以及受体拮抗剂因其良好的有效性和耐受性有望用于预防偏头痛;肉毒毒素肌肉注射可用于慢性偏头痛。由于新药的不断开发,偏头痛治疗的前景越来越光明。
Migraine is a common and chronic disease that is characterized by episodic headache that can cause disability,accompanied by aura and other symptoms.The etiology is relatively unknown,and four rare related genes have been identified.The pathogenesis of migraine may be related to spreading depolarization,which probably causes aura and initiates activation of trigeminal pain pathway,ultimately triggering headache.Vasodilation is possibly a secondary phenomenon.The treatment of migraine varies according to the severity of the attack.Calcitonin gene related peptide(CGRP)receptor antagonists and selective 5-hydroxytryptamine 1F receptor agonist are expected to be effective in acute phase.Monoclonal antibodies targeting CGRP pathways and receptor antagonists are expected to prevent migraine because of their good efficacy and tolerance.Intramuscular injection of botulinum toxin A can be a treatment option for chronic migraine.The emergence of new medications indicates the bright future for migraine management.
作者
宋小燕
王晓平
SONG Xiaoyan;WANG Xiaoping(Department of Neurology,Shanghai General Hospital,Shanghai 200080,China;Neurological Disease Diagnosis and Treatment Center,Shanghai General Hospital Jiading Branch,Shanghai 201804,China)
出处
《世界临床药物》
CAS
2023年第6期527-530,共4页
World Clinical Drug
关键词
偏头痛
诊断
治疗
预防
migraine
diagnosis
treatment
prevention
