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目的探讨与偏头痛慢性化相关的潜在危险因素。方法依据ICHD-Ⅱ(2004)及其关于慢性偏头痛最新修订版(2006)的诊断标准,2006年3月至2008年3月上海仁济医院神经内科头痛门诊连续就诊登记偏头痛患者250例,其中慢性偏头痛43例、发作性偏头痛207例,回顾分析两组患者的人口学资料及头痛病史。结果慢性偏头痛占总偏头痛就诊人数的17.2%。单因素分析结果显示两组中性别构成、教育程度、体力劳动者比例以及存在一级亲属家族史、系统疾病史者的比例相似(P>0.05);头痛严重程度、持续时间、既往发作频率以及存在先兆的比例也无显著差异(P>0.05)。慢性偏头痛组中急性期止痛药物的使用率较对照组明显增高(P=0.0005)。两组患者偏头痛起病年龄相当,但慢性偏头痛组患者病程明显长于对照组,并于多因素分析中仍显示明显差异。结论偏头痛慢性化的风险可能随病程延长而增大,但须行进一步的前瞻性队列研究以证实。在临床工作中,对病程长、可能存在止痛药物滥用的患者应加强治疗及随访。
Objective To explore the potential risk factors associated with migraine headaches. Methods According to ICHD-Ⅱ (2004) and its diagnostic criteria of the latest revision of chronic migraine (2006), from March 2006 to March 2008, 250 patients with migraine were enrolled in consecutive visits of Headache Outpatient Department of Neurology, Shanghai Renji Hospital, There were 43 cases of chronic migraine and 207 cases of migraine. The demographic data and history of headache were retrospectively analyzed. Results Chronic migraines accounted for 17.2% of all migraine headaches. The results of univariate analysis showed that the proportions of gender composition, education level, proportion of manual workers, family history of first-degree relatives and history of systemic diseases were similar (P> 0.05); the severity of headache, duration, past seizure frequency, There is no significant difference in the proportion of threatened (P> 0.05). Chronic migraine group acute phase analgesic drug use rate was significantly higher than the control group (P = 0.0005). Migraine onset age was similar in both groups, but the course of chronic migraine patients was significantly longer than the control group, and in multivariate analysis showed significant differences. Conclusions The risk of migraine headaches may increase with the duration of the disease, but further prospective cohort studies are needed to confirm this. In clinical work, for patients with longer duration of possible analgesic drug abuse should be strengthened treatment and follow-up.