腔隙性脑梗死并发卒中相关性头痛的危险因素分析

Risk factors for ischemic lacunar stroke associated headache

目的分析卒中相关性头痛(stroke-associated headache,SH)在腔隙性脑梗死患者中发生的危险因素和探讨可能的发病机制。方法从南京卒中注册系统中提取首次发病的腔隙性脑梗死患者371例,分析录入信息中的人口学因素、卒中危险因素、临床表现和影像学检查,并通过多因素Logistic回归分析SH危险因素。结果51例患者合并SH,发生率为13·7%;性别、年龄、糖尿病、偏头痛病史、前后循环分布以及中脑位置的梗死在SH组与无SH组对比中有统计学差异(P<0·05),然后通过多因素Logistic逐步回归分析后发现女性、偏头痛病史、后循环以及中脑位置的梗死是腔隙性脑梗死患者并发SH的独立危险因素。结论对腔隙性脑梗死的危险因素分析不但对临床诊疗提供帮助,而且对探讨SH的发生机制有重要意义。

Objective To analyze risk factors of stroke-associated headache （SH） and explore its underlying mechanisms. Methods First-ever lacunar infarction patients （ N = 371 ） were extracted from Nanjing Stroke Registration Program. Demographic data, clinical features, risk factors and neuroimaging findings were analyzed. Results There were 51 （13.7%） patients with SH. The differences in sex, age, diabetes mellitus, history of migraine, and the frequency of anterior circulation, posterior circulation as well as midbrain infarction were significant between groups with and without SH. By Logistic regression analysis, only sex, history of migraine, and the frequency of posterior circulation as well as midbrain infarction were independent variables significantly associated with SH. Conclusions The study on risk factors for SH not only improves the diagnosis and treatment of lacunar infarction, but also provides some insights into the disease mechanisms.