Abstract: Objective To analyze the synergetic effects of neuro-vascular factors in the pathogenesis of migraine.Methods Total 131 patients fulfilling the inclusion criteria of migraine were included in the study. Transcranial Doppler(TCD) and sympathetic skin response(SSR) findings were analyzed for migraineurs. According to the result of TCD and SSR, the significance of the presence of cerebral blood flow velocity and abnormal sympathetic activity were statistically analyzed.Results Elevated cerebral blood flow velocity were found in 87 of 131 patients, significantly different from those patients with normal velocity(136±15 cm/s vs 89±8cm/s, P<0.01). According to the value of SSR, positive result in 78 migraineurs with abnormal blood flow velocity, while negative result in 12 patients of normal velocity, and there was significantly difference between them(59.54% vs 9.16%, P<0.01). There was a statistically significant correlation between peak velocity (Vp) of TCD and latency of SSR(r=0.463, P<0.01) among all migraineurs.Conclusion Migraine is a neurovascular coupling disorder where the cerebral hemodynamics is malfunctioning. TCD combining SSR can assess the change of intracranial hemodynamics, which seems to be effective and safe to study the pathogenesis in the patients with migraine.

Key words: Migraine; Transonography; Doppler; transcranial; Sympathetic skin response

摘要： 目的 探讨血管神经因素在偏头痛发病中的协同作用。方法 131例符合偏头痛诊断的患者，同时进行经颅多普勒（transcranial Doppler，TCD）和皮肤交感反应（sympathetic skin response，SSR）检测，根据TCD收缩期血流速度（peak velocity，Vp）作为分组指标，分析不同脑血流速度下交感活性改变对血液动力学的影响。结果 脑血流速度增高者（高流速组，Vp≥120&#8197;cm/s）87例，正常者（正常流速组，80cm/s&#8197;cm）44例，平均血流速度分别为（136±15）cm/s和（89±8）cm/s（P<0.01）。高流速组SSR检测阳性者78例（59.54%），正常流速组SSR检测阴性者12例（9.16%），两组交感活性分布差异有统计学意义（P<0.01）。TCD检测指标Vp与SSR潜伏期具有明显的相关性（r=0.463，P<0.01）。结论 偏头痛是血管神经协同作用引起的脑血液动力学改变的结果，TCD结合SSR能够有效的评价不同交感活性情况下脑血液动力学的变化，对偏头痛的发病机制研究具有较高参考价值。

关键词: 偏头痛; 超声检查; 多普勒; 经颅; 皮肤交感反应