发作性偏头痛慢性转化的危险因素分析

摘要

Objective :To observe the charactevistic of episodic migraine and chronic migraine, and evaluate the risks of transformation from episodic migraine to chronic migraine.Methods: According to the ICHD-Ⅱ (2004) and the updated appendix criteria for chronic migraine (2006), 149 migraineurs were analyzed including 96 episodic migraineurs and 53 chronic migraineurs.Results: Logistic stepwise regression analysis screened out the following factors: course of disease( OR = 1.067 95％ CI = 1.016 ～ 1.121 ), primary headache episode frequency( OR = 1.089,95％ CI 1.001 ～ 1.185 ), Pittsburgh Sleep Quality Index( OR = 1.352,95％ CI 1.169 ～ 1.563 ), BMI value( OR = 3.010,95％ CI 1.172 ～ 7.730),analgesics overuse( OR = 3.156,95％ CI 1.005 ～ 9.967 ).All of these facts contributed to the transformation of patients from episodic to chronic migraine.Conclusion: Improving quality of sleeping, controlling body weight and professional treatment are essential for episodic migraine patients to keep away from aggravate to chronic migraine.%目的:比较发作性偏头痛和慢性偏头痛的病史特征,寻找发作性偏头痛慢性转换的危险因素.方法:依据国际头痛学会(IHS)2004年头痛最新分类标准和诊断标准,回顾性分析偏头痛病例149例,其中发作性偏头痛96例,慢性偏头痛53例,首先对观察指标作单因素分析,筛选差异有统计学意义的变量进行前向逐步法Logistic回归分析(α=0.05).结果:Logistic逐步回归筛选出病程(OR=1.067,95% CI 1.016～1.121)、初发头痛频率(OR=1.089,95% CI 1.001～1.185)、匹兹堡睡眠指数(OR=1.352,95% CI 1.169～1.563)、BMI值(OR=3.010,95% CI 1.172～7.730)、镇痛药物过度服用史(OR=3.156,95% CI 1.005～9.967)是影响发作性偏头痛慢性转换的危险因素.结论:积极改善睡眠质量,控制体重,合理用药等,有助于降低发作性偏头痛向慢性偏头痛转化的风险.