偏头痛伴发脑微出血的相关危险因素分析

Analysis of risk factors in migraine patients with cerebral microbleeds

目的分析偏头痛患者伴发脑微出血（CMBs）的临床特点及影响因素。方法连续收集178例临床确诊的偏头痛患者,根据头颅MRI有无CMBs表现分为两组,收集患者一般资料,头痛特点并进行比较。结果 （1）178例偏头痛患者中CMBs患者56例,偏头痛合并CMBs发生率为31.5%,其中单发病灶17例（30.4%）,多发病灶39例（69.6%）,单纯脑叶病灶31例（55.4%）;（2）与无CMBs的偏头痛患者比较,合并CMBs的偏头痛患者更容易合并高血压（P=0.028）,头痛病程长（P=0.002）、头痛发作频率高（P=0.001）且容易伴发先兆（P=0.036）;（3）多因素Logistic回归分析显示,在校正年龄、性别及其他危险因素后,头痛病程（OR=1.166,95%CI：1.044～1.303,P=0.007）、头痛发作频率（OR=1.353,95%CI：1.116～1.640,P=0.002）和先兆偏头痛（OR=10.080,95%CI：1.630～62.329,P=0.013）与偏头痛发生CMBs相关。结论偏头痛病程长、发作频率高及伴有先兆是偏头痛发生CMBs的危险因素。

Objective To analyze the clinical features and risk factors of migraine patients with cerebral microbleeds（ CMBs）. Methods One hundred and seventy-eight clinically diagnosed migraine patients were consecutively enrolled in our study. Based on the presence or absence of CMBs in brain MRI,178 migraine patients were divided into two groups. General information and headache characteristics were collected and compared between two groups. Results（ 1） There were 56 patients with CMBs among the 178 migraine patients. The incidence of migraine patients combined with CMBs was 31. 5%. There were 17（ 30. 4%） patients with single lesion,and 39（ 69. 6%） patients with multiple lesions. Lobar CMBs were found in 31（ 55. 4%） patients;（ 2） Compared with nonCMBs group,there were higher incidence of hypertension（ P = 0. 028）,longer disease duration（ P = 0. 002）,higher frequency of headache attack（ P = 0. 001） and higher incidence of aura migraine（ P = 0. 036） in CMBs group;（ 3） After adjusting for age,sex and other risk factors,logistic regression analysis showed that migraine duration（ OR = 1. 166,95% CI： 1. 044- 1. 303,P = 0. 007）,headache frequency（ OR = 1. 353,95% CI：1. 116- 1. 640,P = 0. 002） and aura（ OR = 10. 080,95% CI： 1. 630- 62. 329,P = 0. 013） were still associated with CMBs. Conclusion Longer migraine duration,higher headache frequency and aura are the predictive risk factors of CMBs in migraineurs.