摘要
Migraine is a complex and heterogeneous disorder. Although several genetic models has been proposed including autosomal-dominant/autosomal recessive, sex-linked, sex-limited, mitochondrial, and multi-gene, none of these models can well-explain the transmission of the disease. We hypothesied that migraine is a sex-conditioned inherited disorder （autosomal dominant in females and autosomal recessive in males）. This hypothesis is supported by the evidence such as the locations of genes associated with familial hemiplegic migraine, possibly ＂typical＂ migraine as well （dominantly on chromosome 19p, lq, and 2q）, male：female ratio of prevalence （1：2-1：4）, the mostly youth-onset, the provocation by the contraceptives, the induction by menstruation, and the self-limitation after menopause. Female sex-hormones appear to be the key contributor to a higher prevalence of migraine in female. Socio-environmental factors may also play an important role.
偏头痛是一种复杂的多样性疾患。尽管此前已提出包括常染色体显性/常染色体隐性,伴性性状,限性性状,线粒体性及多基因性遗传模式,但均难以很好地解释该病的遗传性。笔者设想偏头痛为从性性状式(Sex-conditioned)遗传性疾患,即在男性患者为常染色体隐性遗传,在女性为常染色体显性遗传。支持此假设的证据有:家族性偏瘫性偏头痛以及其它一些经典的偏头痛疾病相关基因位于在常染色体19p,1q和2q;男女性别比为1:2-1:4;大多数在青年期前后发病;避孕药可以诱发;月经期好发;女性绝经期常自愈。女性性激素可能是该病在女性中高发的关键因素。此外,环境和人文经济因素亦可能具有重要作用。
