偏头痛患者脑白质损伤的危险因素分析

Analysis of risk factors in migraine patients with white matter lesions

目的分析偏头痛患者脑白质损伤(white matter lesions,WMLs)的临床特点及危险因素。方法收集110例临床确诊的偏头痛患者,根据影像学有无WMLs表现分为两组,对两组患者先进行单因素分析,然后进行多因素非条件Logistic回归模型分析。结果 1110例偏头痛患者中WMLs患者36例,偏头痛合并WMLs发生率为32.7%,WMLs好发于额叶和顶叶(59.1%);2与非WMLs组比较,WMLs组偏头痛患者头痛病程长(5.3±3.7 vs.7.6±4.9,P﹤0.01)、头痛发作频率高(3.5±2.3 vs.4.6±2.2,P﹤0.05),多伴有先兆(18.9%vs.36.1%,P﹤0.05)及偏头痛家族史(12.2%vs.44.4%,P﹤0.01);3多因素Logistic回归分析显示偏头痛家族史(OR=5.995)、先兆偏头痛(OR=3.067)、头痛病程(OR=1.165)是偏头痛发生WMLs的独立危险因素(P﹤0.05)。结论偏头痛家族史、先兆偏头痛及头痛病程长是偏头痛发生WMLs的危险因素。

Objective To analyze the clinical features and risk factors of migraine patients with white matter le-sions （WMLs）. Methods One hundred ten clinically diagnosed migraine patients who underwent magnetic resonance im-aging （MRI） scans from October, 2010 to August, 2013 were enrolled in Shandong Provincial Hospital. One hundred ten migraine patients were divided into two groups：WMLs group and non-WMLs group based on the presence or absence of WMLs in MRI scans. The clinical features of the patients and location and number of WMLs were investigated. Noncondi-tional multivariate stepwise logistic regression after univariate analysis was used to analyze the data. Odds ratio （0R） and 95 confidence interval after adjustment for possible confounding variables were calculated. Results①There were 36 patients with WMLs among the 110 migraine patients. The incidence of WMLs in migraine patients was 32.7%. The WMLs in migraine patients were predominantly present in the frontal and parietal lobes （59.1%）. ② Compared with non-WMLs group, there were significant increases in disease duration （5.3±3.7 vs. 7.6±4.9, P﹤0.01）, frequency of head-ache attack （3.5 ± 2.3 vs. 4.6 ± 2.2, P﹤0.05）, aura （18.9%vs. 36.1%, P﹤0.05） and family history of migraine （12.2%vs. 44.4%, P﹤0.01） in WMLs group.③The independent risk factors of WMLs in migraine patients were family history of mi-graine （OR=5.995）, aura （OR=3.067） and long disease duration （OR=1.165）. Conclusions Family history of migraine, au-ra and disease duration are the predictive risk factors of WMLs in migraineurs.