| Objective:To study the incidence of white matter lesions in migraine patients in Yanbian area and the incidence of white matter lesions in patients with right to left shunt.Characteristics of white matter lesions.To study the relationship between right to left shunt,migraine and white matter lesions,and the relationship between right to left shunt and cryptogenic stroke.It provides a reference for the early identification of cryptogenic stroke in young and middle-aged people in this area.Methods:To collect the clinical data of 432 young migraine patients hospitalized in the Department of Neurology,Yanbian University affiliated Hospital from January 2016 to January 2021,According to the type of migraine,Divided into typical migraine with aura(aura group),migraine without aura(aura group),Data of baseline,transcranial Doppler foaming and head MRI were collected,The baseline data,right-to-left shunt status and white matter lesions were compared between different types of patients.And the leukoencephalopathy was a pathological group,The rest of the patients were included in the control group,Comparison of baseline data,migraine type,right-to-left shunt status between the lesion group and the control group,Binary logistics regression analysis was used to determine the influencing factors of white matter lesions.Partial correlation analysis was used to determine the correlation between right to left shunt and white matter lesions in different types of patients.Results:1、A significant difference was found in the patients with threatened group(P<0.05);The proportion of RLS grade ≥ grade 1 in threatened group was 68.33%(41/60)significantly higher than that in non-predominant group(P<0.05);There was significant difference in RLS grade between the threatened group and the non-predicted group(P<0.05);The RLS grade level of the threatened group was higher than that of the non-monitory group(P<0.05);High signal score of paraventricular and deep white matter in threatened group were significantly higher than those in non threatened group(P<0.05).Cerebral white matter disease incidence in threatened group was 45.00%(27/60)significantly higher than that in non-monitory group(30.00%)(112/372),the difference was statistically significant(P<0.05).2、Univariate analysis,there was no significant difference in age,sex,nationality,migraine pain degree,family history of migraine and complications between the lesion group and the control group(P>0.05).there were significant differences in course,pain duration,RLS grade,paraventricular high signal score,deep white matter signal score in the lesion group(P>0.05).Korean IgA nephropathy patients with systolic blood pressure and diastolic blood pressure and no statistical difference between the han nationality patients,but significantly higher than that of the han nationality,hypertension prevalence Korean difference is statistically significant.3、The risk factors of white matter lesions were RLS grade and migraine type(OR>1,P<0.05).4、the results showed that there was a positive correlation between white matter lesion and RLS grade,paraventricular high signal score and deep white matter signal score(r=0.765,0.378,0.754,all P=0.000),and RLS type was positively correlated with carotid sclerosis degree and cognitive impairment degree(r=0.518,0.415,all P=0.000).Conclusion:1、Compared with migraine without aura,patients with typical migraine have higher incidence of right-to-left shunt and lesions.2、A high risk factor for leukoencephalopathy was elevated RLS grade.The degree of cognitive impairment and carotid sclerosis were higher in patients with elevated RLS grade、leukoencephalopathy.3、For patients with typical aura migraine,the risk of right-to-left shunt should be screened in time.Combined with craniocerebral MRI screening,it can help the early detection of white matter lesions to some extent.Patients with white matter should pay attention to the history of typical migraine and avoid the development of occult stroke. |
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