Abstract:

Objective　To explore the value of β-endorphin (β-EP), cyclooxygenase-2 (COX-2), and dopamine receptor D2 (DRD2) in the prediction of the anxiety conditions in patients with right-to-left shunt (RLS) migraine. Methods　This was a retrospective study. Three hundred patients with RLS migraine treated at Jilin FAW General Hospital from March 2023 to March 2024 were selected as an RLS group, including 171 males and 129 females who were 23-58 years old and whose disease course was 1-9 years. According to the migraine grade, the patients were classified into minor, moderate, and severe RLS migraine groups (144, 99, and 57 cases, respectively). According to the Hamilton Anxiety Scale (HAMA) scores, the patients were divided into an anxious group (96 cases) and a non-anxious group (204 cases). Fifty healthy examinees in the same period were selected as a control group, including 28 males and 22 females who were 24-54 years old. The levels of β-EP, COX-2, and DRD2 were compared between the groups. The Pearson analysis was used to examine the correlations between these indicators. The receiver operating characteristic curves (ROC) were drawn to analyze the predictive efficacy of anxiety conditions in the patients. The data were statistically analyzed by t test, χ² test, and analysis of variance (ANOVA). Results　There were statistical difference in the levels of β-EP, COX-2, and DRD2 between the RLS group and the control group [(83.30±11.60) ng/L vs. (146.85±23.31) ng/L, (1 639.90±206.18) ng/L vs. (834.91±95.69) ng/L, and (1 375.63±164.57) ng/L vs. (2 911.35±332.23) ng/L; all P<0.05]. There were statistical differences in the levels of β-EP, COX-2, and DRD2 between the minor, moderate, and severe RLS migraine groups [(91.58±10.24) ng/L vs. (79.67±9.14) ng/L vs. (68.68±7.72) ng/L, (1 462.35±155.24) ng/L vs. (1 762.28±181.59) ng/L vs. (1 875.90±193.22) ng/L, and (1 538.40±164.81) ng/L vs. (1 289.59±138.57) ng/L vs. (1 113.85±127.65) ng/L; all P<0.05]. There were statistical differences in the levels of β-EP, DRD2, and COX-2 between the anxious group and the non-anxious group [(63.25±7.56) ng/L vs. (92.73±10.67) ng/L, (1 175.68±131.71) ng/L vs. (1 469.72±163.11) ng/L, and (1 852.52±193.28) ng/L vs. (1 539.84±171.66) ng/L; all P<0.05]. The Pearson analysis showed that the HAMA score was negatively correlated with β-EP and DRD2 (r=-0.696 and -0.534; both P<0.001), and positively with COX-2 (r=0.557; P<0.001) in the patients. The ROC results indicated that the area under the curve (AUC), sensitivity, and specificity of the combination of β-EP, COX-2, and DRD2 were 0.976, 97.9%, and 97.5%, respectively, which were higher than those of β-EP (0.943, 94.8%, and 90.7%), COX-2 (0.852, 68.8%, and 89.2%), and DRD2 (0.897, 81.2%, and 87.3%). Conclusion　β-EP, COX-2, and DRD2 have good predictive value for anxiety conditions in patients with RLS migraine.

Key words:

β-endorphin, Cyclooxygenase-2, Dopamine receptor D2, Right-to-left shunt, Migraine, Anxiety

摘要：

目的　探究β-内啡肽（β-EP）、环氧化酶-2（COX-2）、多巴胺受体D2（DRD2）对右向左分流（RLS）偏头痛患者焦虑状况的预测价值。方法　本研究采用回顾性分析，选取2023年3月至2024年3月吉林省一汽总医院收治的300例RLS偏头痛患者（RLS组），其中男171例，女129例，年龄范围23～58岁，病程范围1～9年。根据头痛分级分为少量、中量、大量RLS偏头痛，分别144例、99例、57例；根据汉密尔顿焦虑量表（HAMA）评分分为焦虑组（96例）与非焦虑组（204例）。另选取50例同期健康体检人员作为对照（对照组），其中男28例、女22例，年龄范围24～54岁。比较各组β-EP、COX-2及DRD2水平，利用Pearson分析相关指标的相关性，构建受试者操作特征曲线（ROC），分析各指标在RLS偏头痛患者发生焦虑状况中的预测效能，采用t检验、方差分析、χ²检验进行统计分析。结果　RLS组β-EP为（83.30±11.60）ng/L、COX-2为（1 639.90±206.18）ng/L、DRD2为（1 375.63±164.57）ng/L，对照组分别为（146.85±23.31）ng/L、（834.91±95.69）ng/L、（2 911.35±332.23）ng/L，两组比较差异均有统计学意义（均P<0.05）。少量、中量、大量RLS偏头痛组的β-EP、COX-2、DRD2水平比较［（91.58±10.24）ng/L比（79.67±9.14）ng/L比（68.68±7.72）ng/L、（1 462.35±155.24）ng/L比（1 762.28±181.59）ng/L比（1 875.90±193.22）ng/L、（1 538.40±164.81）ng/L比（1 289.59±138.57）ng/L比（1 113.85±127.65）ng/L］，差异均有统计学意义（均P<0.05）。焦虑组β-EP为（63.25±7.56）ng/L、DRD2为（1 175.68±131.71）ng/L，均低于非焦虑组［（92.73±10.67）ng/L、（1 469.72±163.11）ng/L］，COX-2为（1 852.52±193.28）ng/L，高于非焦虑组的（1 539.84±171.66）ng/L，两组比较差异均有统计学意义（均P<0.05）。Pearson显示，RLS偏头痛患者的β-EP、DRD2与HAMA评分呈负相关（r=-0.696、-0.534，均P<0.001），COX-2水平与HAMA评分呈正相关（r=0.557，P<0.001）。ROC结果表明，β-EP、COX-2、DRD2联合预测的曲线下面积（AUC）值（0.976）、灵敏度（97.9%）、特异度（97.5%）均高于β-EP（0.943、94.8%、90.7%）、COX-2（0.852、68.8%、89.2%）、DRD2（0.897、81.2%、87.3%）单独预测。结论　β-EP、COX-2及DRD2对RLS偏头痛患者焦虑状况有着良好的预测价值。

关键词:

β-内啡肽, 环氧化酶-2, 多巴胺受体D2, 右向左分流, 偏头痛, 焦虑