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ƫͷʹһм巢ԷΪԵƫಫͷʹŻһЪںٴηڰڰڻ˯ߺͷʹ⡣ͷʹǰʱɰ񾭡ϰ


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ڷͷʹʷ϶һƫͷʹʷϲѡǰоԼۼԿ𣬶Ҳɰ鷢ƫͷʹӦͷ­CTɨѪӰȷϡƫͷʹԼӦӰѧ顣ҶҶɳҰȱӾ֢״ŲĽչտɳ­ѹ֢״ͷʹ򨶯ףdz״ԼʧĶ˾ϸ

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Ŀijͷʹ֢״辡ֹͷʹķӦշءҩƣƣļԲֲЧ

һԷ  ӦڰܹϢ߿ɷһʹ˹ƥȣɻûͷʹġŻ߿Ӧ顣

ǰƶԲֲЧ5-HTĴٶҲֱѪáҪ5-HT1AͰҲã˸ýϴ󡣳ǰƬÿƬ100mgǰ1mgڳ׻ʼʹʱ12ƬΪжηҪ4Ƭÿó8Ƭʯǰ0.250.5mgƤ»ע䡣ǹֶġŻ¡ʹʹΧѪܾΡȱѪȸáѪܡΡ߼иáƫ̱͡ۼͺͻƫͷʹҲá

Ӣsumatriptan5-HT1DٶѪи߶ѡá˿ڷ100mg30Ӻͷʹʼ⣬4СʱﵽЧƤע6mgЧ죬֢״24Сʱٴע6mg΢һȫȡڸɡͷѹȸк͹ؽʹżҲơʹļ

ƫͷʹ״̬ƫͷʹɿڷעȱ1mg/kgעACTH50λ500mlˮڣڷ10mg13ΡԷʱϳIJӦעʵҺˮҡ

Ԥ  ÿͷʹ23ӦdzԤҩơҩÿշãҩ2ܼܲЧЧӦ6£𽥼ͣҩ

1.  Ϊ-ϼԼ50%70%Ч1/3˵ķɼһϡһΪ1040mg13ΡСɼٶġʧ֫ʹԾεȲӦ

2.pizotifen,sandomigran 5-HT׿Ҳп鰷ܼáüΪ0.5mgÿ1Σӵÿ3Ρ46£80%ͷʹƻֹͣ˯ƣ͸Уʳڷûᷢ֡

3.ǣmethysergide 5-HT׿Ҫ5-HT2׿áС0.51mg/գʼãһӵ12mgÿ2ΡġŻ¡ѣ˯ȸãڷÿɳָĤ֯-Ĥά6±ͣ1¡̵IJ˲ſá

4.ͨͼ  ĪƽnimodipineflunarizineüĪƽΪ2040mgÿ3Ρҩ︱Сɳͷ衢ͷ͡ġŻ¡ʧ߻ƤȲʡ

5.  100400mgÿ3Ρ

6.amitryptilineΪ࿹ҩֹ5-HTȡڿʹƫͷʹͷʹЧüΪ75150mg/ա

7.ֶclonidineѪ˶࣬нѹáԤƫͷʹЧӦ޸áüΪ0.078mg0.15mgÿ23Ρ

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壬Լ50%мʷŮԲԱƫͷʹ¾ǰк٣ʾܺڷڻˮйءšۡ䡢ǿ̼䡢ѪǡӦѪҩѪƽʳøҰʳƾϣշƫͷʹ

ƫͷʹɸΪѪԴѧ˵Դѧ˵WolffѪԴѧ˵ƫͷʹٴ֡ƫͷʹ­ڶֲѪ٣Ӿı䡢о쳣ƫ̱֢״̶­ڡ⶯ţͷʹ

Ҳòͬƫͷʹ˷ʱеĹ۲ȴδܷ­Ѫܱ仯ͷʹĺ㶨ϵGoltman1­ƫͷʹʱ­ѪšThie1ƫͷʹڵѪӰȴжĿھԽСOlson11ƫͷʹѪӰֶޱ仯Lauritzen133Xe-SPECT۲죬12ͨƫͷʹʱrCBF쳣11ƫͷʹʱ8֢״ӦrCBFȶԲӦƽ17%ͷʹ46СʱδrCBFӵڷЪڵļ飬ƫͷʹ쳣֣1ԵСĵ͹עAndersenӦ133Xe-SPECT۲ƫͷʹʼrCBF3쳣2ֲעͣ7ƫͷʹ֢״ذrCBFȶԲཱུ19%ʱͷʹͷʹѺͷʹʧʱתΪ߹עrCBFȶԲƽ19%2ĸ߹ע24СʱOlsenӦþע133Xeշƫͷʹ254̽ͷԺCBFɽʹ20ml/(100gmin)ֲĵ͹עɳ֢״ʧ󼸸СʱOlesenȲ˵ƫͷʹ˷ȫ̵rCBF۲쵽ǰѴڵ͹עrCBFƽ2530%ǰչͷʹڵ46СʱKobariӦ133XeǿCTⶨֲѪ1CBFڵ106ձƫͷʹ6ƫͷʹڷʼ308Сʱ֢ʧͷʹʱ1CBFձӣɸ߳25%35%ԶƤΪ뻺ڲƫͷʹӦþ­գTCD10ձƫͷʹ˵ļ飬ͷʹڶʾ­״쳣졣35ƫͷʹʱʾѪٶȵ쳣ͿƵThie1ƫͷʹ1ƫͷʹλʱTCD飬Ҳͬķ֡ȶ2ձƫͷʹ99mTc-SPECT飬ֱַڶƫƤҶڵ͹ע

ˣƫͷʹʱ൱һֲ˿ɼѪ١ȼٺ࣬Ѫٶ쳣죬ѪŻھСЩ仯ͷʹ͡׻ͷʹ䲢޺㶨ĹϵЩ仯ԺͷΪҲеı仯ȴǰͷΪͬһ߱쳣ֲȫ۲ͬಡˣһֲͷʹЪҲھֲ͹עѪٶȵ졣֮ƫͷʹѪܹ쳣֮Ĺϵдһ

ƫͷʹʱгһϵı䡣ڣѪ5-ɫ5-HTжݵߣͷʹʱ5-HTĴл5-ᣨ5-HIAAӡʾѪе5-HTܿ챻ų5-HTƽ˫ãѪ5-HTСϴšС֯ȱѪ׻ϵ֢״ͷʹ5-HT©ѪΧϸҺУ鰷ġѪܳۻĵһʹѪܱʹнͼ¶ġ޾֢Ѫźϲ޾֢ƫͷʹٴ֢״5-HTҪѪСڣѪСۼ߻5-HTͷʱѪС5-HTͻȻ½ͬʱٴijЩҩѪƽͷźͺĽ5-HTãշƫͷʹߵͷʹ5-HTϼ¼णӦԤƫͷʹͷʹڵøMAOԽͿܺ5-HTʱĴMAOйء

ʵ֤ʵƫͷʹ˵ѪС˵ĸ׾ۼѪСۼͷ5-HTADP鰷ءȥϩᣨAAѪ˨A2TXA2ʣЩܽһʹѪСۼþͲĶ豾ӰAATXA2ǿѪܼѪáǰE1ʹƫͷʹ߲ͷʹƼǰصĺϳɣЩŮøߴƼҩշƫͷʹ

ӰȫĹ㷺Ѫܵڻϰı䣬ΪʲôֻͷʹΪʲôͷʹƫԵģʱҽģ

Դѧ˵ΪƫͷʹķԴϵͳڷڸı估Ѫϰһ̷ּ󣬼ƫͷʹѪԷǼ̷ġͷšƫͷʹֵĸָ֢״ǴƤʹҵĽ/Ե˷½ͷʹ

м5-HTԪ֧ijЩͷ­ѪܣǵϸֱλԸɵ߼ʺˡšǡƣͻصԸԪ˷ܼͷ࣬ͷ­Ѫ˶ı䣬ȱѪѪܵġ޾֢̼Ѫĩҵ˺ڲʹС⣬ĩͷѪܻʣѪź²࣬PʣУ­Ѫܡ

ٴ֡


1988ͷʹѧƶĹͷʹ༰ϱ׼ҹٴʵֱ¡

һ׵ƫͷʹձƫͷʹΪжȵضȲͷʹġŻ»η⡣ʹͷʹӾ硣ʼʱΪᵽжȵĶʹʸУӵСʱﵽصIJʹʹԼ2/3ΪһͷʹҲΪ˫ͷʹʱʹϾ粿ͷʹ472Сʱ˯ߺ󳣼⡣ȷ϶ڡ90%ķ¾س¾ƫͷʹٳ5Σ­Լ󷽿ϡ

׵ƫͷʹƫͷʹɷΪ׺ͷʹڣ

1.  Ӿ֢״η⣬ǰ⡢𻨣ӻþ̶Ұȱ𡢰㡢ƫäʧ˿ɳƫľƫ̱ϰ״520ӡ

2.ͷʹ  ׿ʼʱ֡ʹʼһϡ󲿻𽥼ضչͷͷͷʹΪԣʹ̶𽥼طչɳԾʹġŻ¡η⡢ηеIJ沿죬۽ĤѪеIJɫ԰ףήңʳһηɳ13գͨ˯ͷʹԻ⣬վ뵡Ъһƫͷʹɷֳɼͣ

1е׵ƫͷʹƫͷʹƫ̱ƫͷʹʧƫͷʹȡٳֹ2ͷųԼϷɳ

2ӳ׵ƫͷʹƫͷʹ֢״ͬ1ͷʹԳ־ôڣʱ䳬1Сʱ1ܡӰѧ鲻ܷ­ڽṹ

3ƫͷʹԭƻ׶ƫͷʹȷԴԸɻ˫Ҷ֢״ʧ˫ͱDzҰеӾ֢״ϰѣΡˡӡʧ˫Ըо쳣˫̱ҵȡ1Сʱʧ̶˫ͷʹ϶һ

4ͷʹƫͷʹףƫͷʹλּƫͷʹĸ֢״ʱ䲢ͷʹ佥ϣͷʹȫʧȻз֢״ȫΪ֢״ͷʹ١40״η飬Ѫ˨˨TIA

ۼƫͷʹ  ټ30¡й̶һͷʹʷһνϾͷʹۿʹ󣬳ͬۼԣ´ԳջָܺʼηȫָηۼԶָӰų­Բ

ģͯԷѣΣƫͷʹλƫͷʹʷͯͷʹΪΡݵѣηҲɳַƽʧǣŻ¡ϵͳԵͼ϶һֶͯתΪƫͷʹ

壩ƫͷʹ״̬  ƫͷʹʱ72Сʱϣж4СʱĻڣijƫͷʹ״̬

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