卵圆孔未闭相关偏头痛介入封堵治疗进展
Progress in Interventional Closure of Patent Foramen Ovale for the Treatment of Related Migraine
摘要: 卵圆孔未闭是一种常见的先天性心脏结构异常，在普通成年人群中的发病率达20%~30%。偏头痛是一种常见的慢性致残性神经系统疾病。近年研究发现，卵圆孔未闭患者偏头痛的概率较高，提示两者存在关联。随着介入技术的进步，PFO封堵术在偏头痛治疗中的应用逐渐受到关注，但卵圆孔未闭患者偏头痛高发病率的具体机制尚不明确，卵圆孔未闭封堵治疗偏头痛的临床效果存在争议。本研究将综述卵圆孔未闭与偏头痛之间的关系，探讨两者之间潜在的发病机制，分析介入封堵治疗偏头痛的临床效果，包括回顾性研究和随机对照试验的最新证据，对当前治疗现状进行综述。
Abstract: Patent foramen ovale is a common congenital structural abnormality of the heart, with an incidence of 20%~30% in the general adult population. Migraine is a common chronic disabling nervous system disease. Recent studies have found that patients with patent foramen ovale have a higher probability of migraine, suggesting that there is a correlation between them. With the progress of interventional technology, the application of PFO occlusion in migraine treatment has gradually attracted attention, but the specific mechanism of high incidence of migraine in patients with patent foramen ovale is not clear, and the clinical effect of PFO occlusion in migraine treatment is controversial. This study will summarize the relationship between patent foramen ovale and migraine, explore the potential pathogenesis between them, analyze the clinical effect of interventional closure for migraine, including the latest evidence of retrospective studies and randomized controlled trials, and review the current treatment status.
文章引用：汤佛生, 谭贵飞, 温佩珊, 蔡九妹. 卵圆孔未闭相关偏头痛介入封堵治疗进展[J]. 临床医学进展, 2026, 16(2): 2977-2984. https://doi.org/10.12677/acm.2026.162709

参考文献

[1] Miranda, B., Fonseca, A.C. and Ferro, J.M. (2018) Patent Foramen Ovale and Stroke. Journal of Neurology, 265, 1943-1949. [Google Scholar] [CrossRef] [PubMed]
[2] Koutroulou, I., Tsivgoulis, G., Tsalikakis, D., Karacostas, D., Grigoriadis, N. and Karapanayiotides, T. (2020) Epidemiology of Patent Foramen Ovale in General Population and in Stroke Patients: A Narrative Review. Frontiers in Neurology, 11, Article 281. [Google Scholar] [CrossRef] [PubMed]
[3] Ailani, J., Burch, R.C. and Robbins, M.S. (2021) The American Headache Society Consensus Statement: Update on Integrating New Migraine Treatments into Clinical Practice. Headache: The Journal of Head and Face Pain, 61, 1021-1039. [Google Scholar] [CrossRef] [PubMed]
[4] Stovner, L.J., Nichols, E., Steiner, T.J., Abd-Allah, F., Abdelalim, A., Al-Raddadi, R.M., et al. (2018) Global, Regional, and National Burden of Migraine and Tension-Type Headache, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 17, 954-976. [Google Scholar] [CrossRef] [PubMed]
[5] Stovner, L.J., Hagen, K., Linde, M. and Steiner, T.J. (2022) The Global Prevalence of Headache: An Update, with Analysis of the Influences of Methodological Factors on Prevalence Estimates. The Journal of Headache and Pain, 23, Article 34. [Google Scholar] [CrossRef] [PubMed]
[6] Cho, K.K., Khanna, S., Lo, P., Cheng, D. and Roy, D. (2021) Persistent Pathology of the Patent Foramen Ovale: A Review of the Literature. Medical Journal of Australia, 215, 89-93. [Google Scholar] [CrossRef] [PubMed]
[7] Caso, V., Turc, G., Abdul-Rahim, A.H., Castro, P., Hussain, S., Lal, A., et al. (2024) European Stroke Organisation (ESO) Guidelines on the Diagnosis and Management of Patent Foramen Ovale (PFO) after Stroke. European Stroke Journal, 9, 800-834. [Google Scholar] [CrossRef] [PubMed]
[8] Küper, M., Rabe, K., Holle, D., Savidou, I., Dommes, P., Frings, M., et al. (2013) Prevalence of Cardiac Right Left Shunts in Migraine: A Population-Based Case-Control Study. Neurological Sciences, 34, 205-208. [Google Scholar] [CrossRef] [PubMed]
[9] Rundek, T., Elkind, M.S.V., Di Tullio, M.R., et al. (2008) Patent Foramen Ovale and Migraine: A Cross-Sectional Study from the Northern Manhattan Study (NOMAS). Circulation, 118, 1419-1424.
[10] Del Sette, M., Angeli, S., Leandri, M., Ferriero, G., Bruzzone, G.L., Finocchi, C., et al. (1998) Migraine with Aura and Right-to-Left Shunt on Transcranial Doppler: A Case-Control Study. Cerebrovascular Diseases, 8, 327-330. [Google Scholar] [CrossRef] [PubMed]
[11] Zhao, Q., Liu, R., Zhou, J., et al. (2021) Prevalence and Grade of RLS in Migraine: A Prospective Study of 251 Migraineurs by Synchronous Test of c-TTE and c-TCD. Medicine, 100, e24175.
[12] Sztajzel, R., Genoud, D., Roth, S., Mermillod, B. and Le Floch‐Rohr, J. (2003) Patent Foramen Ovale, a Possible Cause of Symptomatic Migraine: A Study of 74 Patients with Acute Ischemic Stroke. Headache: The Journal of Head and Face Pain, 43, 305-306. [Google Scholar] [CrossRef] 
[13] Takagi, H., Umemoto, T. and ALICE (All-Literature Investigation of Cardiovascular Evidence) Group (2016) A Meta-Analysis of Case-Control Studies of the Association of Migraine and Patent Foramen Ovale. Journal of Cardiology, 67, 493-503.
[14] Zhou, G., Liu, A., Zhang, Y., et al. (2024) Study on the Correlation between Patent Foramen Ovale and Migraine Based on Meta Analysis. Alternative Therapies in Health and Medicine, 2024, AT10801.
[15] 田大臣, 王浩, 陈旺, 等. 卵圆孔未闭与偏头痛发病相关性的Meta分析[J]. 神经损伤功能重建, 2019, 14(5): 236-240.
[16] Wang, S.B., Liu, K.D., Yang, Y.I., et al. (2018) Prevalence and Extent of Right-to-Left Shunt on Contrast-Enhanced Transcranial Doppler in Chinese Patients with Migraine in a Multicentre Case-Control Study. Cephalalgia, 38, 690-696. [Google Scholar] [CrossRef] [PubMed]
[17] Beneki, E., Dimitriadis, K., Campens, L., Skalidis, I., Pyrpyris, N., Kostakis, P., et al. (2024) The Modern Clinician as an “Argonaut” Guiding through the “Symplegades” of Evidence for PFO Closure in Patients with Migraine. Cardiology in Review. [Google Scholar] [CrossRef] [PubMed]
[18] Khasiyev, F., Arsava, E.M. and Topcuoglu, M.A. (2020) Cerebral Vasomotor Reactivity in Migraine: Effect of Patent Foramen Ovale and Aerogenic Microembolism. Neurological Research, 42, 795-804. [Google Scholar] [CrossRef] [PubMed]
[19] Liu, K., Wang, B.Z., Hao, Y., Song, S. and Pan, M. (2020) The Correlation between Migraine and Patent Foramen Ovale. Frontiers in Neurology, 11, Article 543485. [Google Scholar] [CrossRef] [PubMed]
[20] Schürks, M., Rist, P.M. and Kurth, T. (2010) MTHFR 677C>T and ACE D/I Polymorphisms in Migraine: A Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain, 50, 588-599. [Google Scholar] [CrossRef] [PubMed]
[21] Wilmshurst, P., Nightingale, S., Walsh, K. and Morrison, W. (2000) Effect on Migraine of Closure of Cardiac Right-to-Left Shunts to Prevent Recurrence of Decompression Illness or Stroke or for Haemodynamic Reasons. The Lancet, 356, 1648-1651. [Google Scholar] [CrossRef] [PubMed]
[22] 王云立, 魏志梁, 尹月娇, 等. 卵圆孔未闭合并偏头痛的相关性分析及介入封堵术疗效评价[J]. 中国循证心血管医学杂志, 2023, 15(9): 1119-1123.
[23] 唐仕海, 周洋, 赵飞, 等. 卵圆孔未闭合并偏头痛患者行经股静脉介入封堵术的临床疗效和安全性分析[J]. 岭南心血管病杂志, 2022, 28(2): 116-121.
[24] Carroll, J.D. (2008) Migraine Intervention with Star Flex Technology Trial: A Controversial Trial of Migraine and Patent Foramen Ovale Closure. Circulation, 117, 1358-1360.
[25] Mattle, H.P., Evers, S., Hildick-Smith, D., Becker, W.J., Baumgartner, H., Chataway, J., et al. (2015) Percutaneous Closure of Patent Foramen Ovale in Migraine with Aura, a Randomized Controlled Trial. European Heart Journal, 37, 2029-2036. [Google Scholar] [CrossRef] [PubMed]
[26] Tobis, J.M., Charles, A., Silberstein, S.D., Sorensen, S., Maini, B., Horwitz, P.A., et al. (2017) Percutaneous Closure of Patent Foramen Ovale in Patients with Migraine: The PREMIUM Trial. Journal of the American College of Cardiology, 70, 2766-2774. [Google Scholar] [CrossRef] [PubMed]
[27] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 卵圆孔未闭规范化诊疗中国专家共识[J]. 中华心血管病杂志, 2024, 52(4): 369-383.

为你推荐