发作性偏头痛慢性转化的影响因素

Influencing factors in chronicity of episodic migraine

目的 探讨发作性偏头痛慢性转化的影响因素.方法 收集126例发作性偏头痛（EM）和50例慢性偏头痛（CM）患者的临床资料,并进行比较.采用Logistic多元回归方法分析偏头痛慢性转化的独立危险因素.结果 EM组超重、女性比率,年龄及体重指数（BMI）显著低于CM组（均P＜0.01）,受教育年限显著高于CM组（P＜0.05）.两组间起病年龄、初发持续时间、初发疼痛程度及有先兆的比率差异无统计学意义（均P＞0.05）.EM组初发频率、病程、急性期止痛药物过度使用比率以及焦虑自评量表（SAS）、抑郁自评量表（SDS）、匹兹堡睡眠质量指数评分均显著低于CM组（P＜0.05～0.01）.BMI（OR=1.159,95％ CI：1.004 ～1.338）、SAS（OR=3.100,95％ CI：1.360 ～ 7.069）、SDS（OR=3.390,95％ CI：1.117～10.287）及急性期止痛药物过度使用（OR=2.714,95％ CI：1.022 ～7.204）是EM慢性转化的独立危险因素（均P＜0.05）.结论 伴有抑郁/焦虑、止痛药物过度使用和超重是EM慢性转化的独立危险因素.

Objective To investigate influencing factors in chronicity of episodic migraine. Methods The clinical data of 126 episodic migraine （EM） patients and 50 chronic migraine （CM） patients were evaluated, and the results were compared. Muhivariable logistic regression analyses were used to predicted independent risk factors in chronicity of episodic migraine. Results The rates of overweight, female and age, body mass index （BMI） in EM group were significantly lower than those in CM group （ all P 〈 0.01 ）. The education years in EM group was significantly higher than that in CM group （P 〈 0. 05）. There was no significant difference in the age onset, duration of intial onset, pain degrees of initial onset and the proportion of aura （all P 〉 0. 05）. The incipient frequency of headache, course of disease, the rate of analgesics overuse in acute stage, the score of self-rating anxiety scale （SAS）, self-rating depression scale （SDS） and Pittsburgh sleep quality index in EM group were significantly lower than those in CM group （ P 〈 0. 05 - 0.01 ）. BMI （ OR = 1. 159, 95% CI： 1. 004 - 1. 338）, SAS （ OR = 3. 100, 95%CI：1.360-7.069）, SDS （OR =3.390, 95%CI：1. 117-10.287） and analgesics overuse （OR =2.714, 95% CI：I. 022 -7. 204） were the independent risk factors in the chronicity of EM （all P 〈 0.05 ）. Conclusion Depression or anxiety, analgesics overuse and overweight are independent risk factors in the chronicity of EM.