偏头痛患者脑白质损伤的危险因素分析.pdf

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1、中国神经精神疾病杂志2014年第4O卷第7期405·论著偏头痛患者脑白质损伤的危险因素分析张君陈春富李聪聪肖萧陈螈【摘要】目的分析偏头痛患者脑白质损伤(whitematterlesions，WMLs)的临床特点及危险因素。方法收集110例临床确诊的偏头痛患者，根据影像学有无WMLs表现分为两组，对两组患者先进行单因素分析，然后进行多因素非条件Logistic回归模型分析。结果①110例偏头痛患者中WMLs患者36例，偏头痛合并WMLs发生率为32．7％，WMLs好发于额叶和顶叶(59．1％)；②与非WMLs组比较，WMLs组偏头痛患者头痛病

2、程长(5．3±3．7VS．7．6±4．9，P<0．01)、头痛发作频率高(3．5±2．3VS．4．6±2．2，P<0．05)，多伴有先兆(18．9％VS．36．1％，P<0．05)及偏头痛家族史(12．2％VS．44．4％，PO．01)；③多因素Logistic回归分析显示偏头痛家族史(OR=5．995)、先兆偏头痛(OR=3．067)、头痛病程(OR=1．165)是偏头痛发生WMLs的独立危险因素(Pc0．05)。结论偏头痛家族史、先兆偏头痛及头痛病程长是偏头痛发生WMLs的危险因素。【关键词】偏头痛脑白质疏松危险因素【中图分类号】R74

3、7．2【文献标识码】AAnalysisofriskfactorsinmigrainepatientswithwhitematterlesions．ZHANGJun，CHENChunfu,LIco凡g—eong,XIA0Xiao，CHENYuan．DepartmentofNeurology,ShandongProvincialHospitalAfiliatedtoShandongUniversity,Jinan250021，China．Tel：0531-68776565．[Abstract]ObjectiveToanalyzetheclini

4、calfeaturesandriskfactorsofmigrainepatientswithwhitematterle—sions(WMLs)．MethodsOnehundredtenclinicallydiagnosedmigrainepatientswhounderwentmagneticresonanceim—aging(MRI)scansfromOctober，2010toAugust，2013wereenrolledinShandongProvincialHospita1．Onehundredtenmigrainepatient

5、sweredividedintotwogroups：WMLsgroupandnon—WMLsgroupbasedonthepresenceorabsenceofWMLsinMRIscans．TheclinicalfeaturesofthepatientsandlocationandnumberofWMLswereinvestigated．Noncondi—tionalmultivariatestepwiselogisticregressionafterunivariateanalysiswasusedtoanalyzethedata．Odd

6、sratio(∞and95confidenceintervalafteradjustmentforpossibleconfoundingvariableswerecalculated．ResultsTherewere36patientswithWMLsamongthe110migrainepatients．TheincidenceofWMLsinmigrainepatientswas32．7％．TheWMLsinmigrainepatientswerepredominantlypresentinthefrontalandparietallo

7、bes(59．1％)．②Comparedwithnon—WMLsgroup．thereweresignificantincreasesindiseaseduration(5．3±3．7VS．7．6±4．9，P<0．O1)，frequencyofhead·acheattack(3．5+2．31)S．4．6~2．2，P<0．05)，aura(18．9％．36．1％，P<0．05)andfamilyhistoryofmigraine(12．2％VS．44-4％．尸<0．01)inWMLsgroup．~Theindependentriskfacto

8、rsofWMLsinmigrainepatientswerefamilyhistoryofmi—graine(OR=5．995)，aura(017=3．067)andlongdi