偏头痛慢性转化的临床危险因素分析

目的比较慢性偏头痛(CM)与发作性偏头痛(EM)的病史特征、临床特点等,探究偏头痛慢性转化的危险因素,为其防治提供依据和策略。方法共纳入在中南大学湘雅医院神经内科就诊的CM患者72例及EM患者109例进行回顾性分析。采集患者基本信息,先进行单因素分析,筛选有统计学意义的指标进行相关分析和非条件性多因素logistic回归分析。结果单因素分析发现两组的BMI(P=0.000)、病程(P=0.000)、基线头痛发作频率(P=0.000)、基线头痛持续时间(P=0.037)、匹兹堡睡眠质量指数量表(PSQI,P=0.000)、焦虑自评量表(SAS,P=0.000)及抑郁自评量表(SDS,P=0.001)差异有统计学意义。logistic回归分析显示BMI(OR=1.468,95%CI:1.148～1.876)、病程(OR=1.102,95%CI:1.022～1.188)、基线头痛发作频率(OR=1.461,95%CI:1.247～1.711)、睡眠质量(OR=1.494,95%CI:1.198～1.864)、焦虑状态(OR=1.201,95%CI:1.048～1.376)是偏头痛慢性转化的危险因素。结论控制体重、减少头痛发作频率、缩短病程、改善心境状态与睡眠质量,有可能延缓偏头痛的慢性进展。

Clinical risk factors for chronicity of migraine

Objective To investigate the differences in medical history and clinical features between chronic migraine (CM) and episodic migraine (EM) and the risk factors for chronicity of migraine, and to provide reference and strategies for prevention and treatment.Methods A retrospective analysis was performed for the clinical data of 72 patients with CM and 109 patients with EM who attended Department of Neurology, Xiangya Hospital of Central South University. Basic information was collected; a univariate analysis was performed to screen out the indices with statistical significance, and then a correlation analysis and an unconditional multivariate logistic regression analysis were performed.Results The univariate analysis showed that there were significant differences between the two groups in body mass index (BMI) (P=0.000), course of disease (P=0.000), frequency of headache at baseline (P=0.000), duration of headache at baseline (P=0.037), Pittsburgh Sleep Quality Index (PSQI) (P=0.000), Self-Rating Anxiety Scale (SAS) score (P=0.000), and Self-Rating Depression Scale (SDS) score (P=0.001). The logistic regression analysis showed that BMI (odds ratioOR]=1.468, 95% confidence intervalCI]:1.148-1.876), course of disease (OR=1.102, 95%CI:1.022-1.188), frequency of headache at baseline (OR=1.461, 95%CI:1.247-1.711), sleep quality (OR=1.494, 95%CI:1.198-1.864), and anxiety status (OR=1.201, 95%CI:1.048-1.376) were risk factors for chronicity of migraine.Conclusions Weight control, timely treatment to reduce the frequency of headache attacks and shorten the course of disease, and improvement of mood and sleep quality may delay the chronic progression of migraine.