中青年偏头痛患者脑血管反应性影响因素分析

Influencing Factors of Cerebral Vascular Reactivity in Young and Middle-Aged Patients with Migraine

目的分析中青年偏头痛患者脑血管反应性(CVR)的影响因素。方法收集2022年7月—2023年12月在湖南省第二人民医院超声医学科就诊的108例中青年偏头痛患者为研究对象。收集患者的临床资料,根据经颅多普勒(TCD)屏气试验结果,将患者分为CVR受损组(57例)和CVR正常组(51例)。采用多因素Logistic回归分析探讨中青年偏头痛患者CVR的影响因素。结果CVR受损组有失眠症、抑郁症、焦虑症、卵圆孔未闭(PFO)者占比高于CVR正常组,P波最大时限(Pmax)、P波离散度(Pd)长于CVR正常组(P<0.05)。多因素Logistic回归分析结果显示,失眠症〔OR=5.421,95%CI(1.088~26.995)〕、抑郁症〔OR=4.369,95%CI(1.022~18.679)〕、焦虑症〔OR=8.529,95%CI(1.480~49.143)〕、Pd〔OR=1.168,95%CI(1.067~1.279)〕、PFO〔OR=5.137,95%CI(1.189~22.190)〕是中青年偏头痛患者CVR受损的影响因素(P<0.05)。结论失眠症、抑郁症、焦虑症、Pd、PFO是中青年偏头痛患者CVR受损的影响因素。

Objective To analyze the influencing factors of cerebral vascular reactivity(CVR)in young and middleaged patients with migraine.Methods A total of 108 young and middle-aged patients with migraine admitted to the Department of Ultrasound Medicine of the Second People's Hospital of Hunan Province from July 2022 to December 2023 were selected as the study subjects.Clinical data of the patients were collected.Based on the results of the transcranial doppler(TCD)breath-holding test,patients were divided into the CVR-impaired group(57 cases)and the CVR-normal group(51 cases).Multivariate Logistic regression analysis was used to explore the influencing factors of CVR in young and middle-aged patients with migraine.Results The proportion of patients with insomnia,depression,anxiety,and patent foramen ovale(PFO)was higher in the CVR-impaired group than in the CVR-normal group,the maximum P-wave duration(Pmax)and P-wave dispersion(Pd)were longer in the CVR-impaired group than in the CVR-normal group(P<0.05).Multivariate Logistic regression analysis showed that insomnia[OR=5.421,95%CI(1.088-26.995)],depression[OR=4.369,95%CI(1.022-18.679)],anxiety[OR=8.529,95%CI(1.480-49.143)],Pd[OR=1.168,95%CI(1.067-1.279)],and PFO[OR=5.137,95%CI(1.189-22.190)]were influencing factors of CVR impairment in young and middle-aged patients with migraine(P<0.05).Conclusion Insomnia,depression,anxiety,Pd,and PFO are influencing factors of CVR impairment in young and middle-aged patients with migraine.