Objective To investigate the prevalence of right-to-left shunt ( RLS) in migraine patients and analyze the relationship between migraine and right to left shunt .Methods 116 cases of migraine patients and 75 healthy volun-teers as control group ,using contrast enhanced transcranial Doppler ( c-TCD) for diagnosis of RLS and grade ,the positive rate of the two groups were statistically analyzed .Results In the case group,the positive rate of RLS was 50.9％ (59/116),of which grade Ⅰshunt accounted for 30.2％ ( n=35),grade Ⅱ shunt accounted for 2.6％ ( n=3),grade Ⅲ shunt accounted for 6.0％(n=7),and grade Ⅳ shunt accounted for 12.1％(n=14).In the control group,the positive rate of RLS was 30.6％(23/75),of which grade Ⅰshunt accounted for 24.0％(n=18),the grade Ⅱ shunt accounted for 1.3％(n=1),grade Ⅲ shunt accounted for 0％(n=0),and grade Ⅳ shunt accounted for 5.3％(n=4).Compari-son of two groups of the total positive rate ,the total positive rate of case group was higher than the control group ,there was statistically significant difference (P=0.006,χ2 =7.583).Large shunt rate in case group was significantly higher than the control group (P=0.011,χ2 =6.530),but the two groups of small shunt rate had no significant difference (P=0.273,χ2=1.199).Conclusion Migraine is related to right-to-left shunt,and the large shunt may be the cause of migraine ,which should be paid more attention to .%目的 观察偏头痛患者右向左分流(right-to-left shunt,RLS)的发生率,分析偏头痛与右向左分流的相关性.方法 入选116例确诊为偏头痛的患者为病例组,75例健康志愿者为对照组,应用对比增强经颅多普勒超声(contrast-enhanced transcranial Doppler,c-TCD)诊断RLS并对分流量进行分级,分析两组的阳性率,进行统计分析.结果 病例组中,RLS的阳性率为50.9％(59/116),其中,Ⅰ级分流35例(30.2％),Ⅱ级分流3例(2.6％),Ⅲ级分流7例(6.0％),Ⅳ级分流14例(12.1％).对照组中,RLS的阳性率为30.6％(23/75),其中,Ⅰ级分流18例(24.0％),Ⅱ级分流1例(1.3％),Ⅲ级分流0例(0％),Ⅳ级分流4例(5.3％).两组RLS总阳性率的比较,病例组的RLS总阳性率高于对照组,统计学有显著差异(P=0.006,χ2=7.583);病例组的大量分流率显著高于对照组(P=0.011,χ2=6.530),但两组的小量分流率比较无统计学差异(P=0.273,χ2=1.199).结论 偏头痛与右向左分流存在相关,大量分流可能是偏头痛的病因,应引起临床重点关注.
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