伴先兆偏头痛和不伴先兆偏头痛大学生患者合并焦虑抑郁症状的差异性比较

Differences between Undergraduate Migraine with Aura and Migraine without Aura Combined with Anxiety and Depression

目的探讨伴先兆偏头痛(MA)和不伴先兆偏头痛(MOA)大学生患者合并焦虑、抑郁症状的情况及差异。方法2018年7月至2019年7月,将中国四川省北部川北医学院通过整群抽样的方式,应用头痛筛查量表(ID-Migraine)初步筛选偏头痛病例,对ID-Migraine初筛结果阳性的大学生进一步通过神经内科医生根据ICHD-3beta量表明确诊断为偏头痛患者纳入研究,按照是否伴先兆症状分为MA组和MOA组。伦理审核后采集个人信息和头痛基本信息,使用汉密尔顿焦虑(HAMA)量表、汉密尔顿抑郁(HAMD)量表进行头痛和精神状况评估。结果1037例大学生完成了ID-Migraine评估,其中579例诊断为偏头痛,纳入统计分析数据的有561例。MA组患者75例,合并一种及以上精神障碍的有65/75例(86.67%);MOA组患者486例,合并焦虑或者抑郁的有369/486例(75.92%),两组间比较差异有统计学意义(P=0.039)。MA组的头痛持续时间及偏头痛家族史与MOA组比较,差异有显著统计学意义(分别P<0.001和=0.018),MA组的HAMA量表(P=0.005)和HAMD量表(P=0.000)评分均高于MOA组。结论医学院学生偏头痛患者合并焦虑、抑郁发病率高,MA组高于MOA组,MA对患者精神情绪的影响程度更重。

Aim To explore migraine with aura(MA)and migraine without aura(MOA)caused by mental disorders and differences.Methods From July 2018 to July 2019,a cluster sampling method was used in a medical school in the northern part of Sichuan Province,and Headache Screening Scale(ID-Migraine)was used to initially screen migraine cases,undergraduates with positive ID-Migraine initial screening results were further included in the study by neurologists who were diagnosed as migraine patients based on ICHD-3 beta.After ethical review,personal information and basic headache information were collected.Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to assess headaches and mental conditions.Results In the end,1037 students completed the assessment,579 were diagnosed with migraine,and 561 were included in the analysis.Among them,there are 75 patients with MA(MA group)and 65 patients with one or more mental disorders(86.67%).Among the 486 MOA patients(MOA group),there are 369(75.92%)who had one or more mental disorders(P=0.039).The duration of headache and family history of migraine in the MA group were significantly different from those in the MOA group(P<0.001 and=0.018),and HAMA(P=0.005)and HAMD(P=0.000)scores of MA group were all higher than those of MOA group.Conclusion The incidence of migraine complicated by mental disorder among college students in medical school was high,the incidence of MA group was higher than that of MOA group,and MA had a deeper influence on mental mood.