184例丛集性头痛病人临床特点分析

Clinical features of cluster headache: A clinic-based survey for 184 patients

目的:研究我国丛集性头痛(cluster headache, CH)病人的临床特点。方法:收集2019年1月至2021年2月就诊于中国人民解放军总医院第一医学中心神经内科的CH病人相关临床信息并分析。结果:在184例CH病人中,男:女=5.6:1,发作性CH占97.3%,慢性CH占2.7%。平均病程为(11.4±7.9)年,发病平均年龄为(22.5±8.6)岁,男性发病年龄大于女性(23.1±8.8岁vs. 19.3±6.0岁,P=0.008)。有20.2%的病人同时患有其他类型的头痛。28.8%的病人有头痛家族史。有22.6%的病人不同丛集期之间头痛偏侧会变化,最常见的疼痛部位是颞部(140例,76.1%)。单次头痛发作的持续时间中位数为90 (60~120)分钟,有87.0%的病人头痛发作频率在每日2次及以下。每年丛集期发作频率少于1次者最多(50.0%),丛集期持续天数平均为(37.6±28.9)天。结论:CH病人中女性比例较既往有所升高,女性比男性发病年龄早,部分病人存在头痛家族史、头痛偏侧变化和不典型的头痛部位。

Objective: To investigate the clinical features of patients with cluster headache(CH) in China. Methods: Patients with CH admitted to the Department of Neurology of the First Medical Center of PLA General Hospital from January 2019 to February 2021 were enrolled, and clinical information were collected and analyzed. Results: In the 184 CH patients, with male-to-female ratio of 5.6:1, 97.3% had episodic CH and 2.7% had chronic CH. The average duration of disease was 11.4±7.9 years, and the average age of onset was 22.5±8.5 years. The onset age of male was higher than that of female(23.1±8.8 years vs. 19.3±6.0 years, P = 0.008). A positive headache family history was reported by 28.8% of patients. And 20.2% patients have comorbidity with other types of headache. In 22.6% of the patients, there was a variation in headache laterality between cluster bouts. The most commonly reported location of cluster headache was temporal region(140 cases, 76.1%). The median duration of a headache attack was 90(60-120) minutes, and 87.0% of the patients had headache frequency of 2 times per day or less. The most frequency of cluster bout was less than once a year(50.0%), and the average duration of the cluster bout was 37.6±28.9 days. Conclusion: The proportion of female patients is higher than previous reports, and the onset age of female patients is earlier than that of male patients. In the meantime, some patients had family history of headache, variation in headache laterality between cluster bouts, and atypical headache locations.