丛集性头痛临床特征与疗效观察  

Clinical features and curative observation of cluster headache

作　　者：王达岩 黎伦晞 邓勇[1] 张艺馨[1] 谭戈[1] 

机构地区：[1]重庆医科大学附属第一医院神经内科,重庆400016

出　　处：《重庆医科大学学报》2017年第10期1249-1253,共5页Journal of Chongqing Medical University

基　　金：国家自然科学基金资助项目(编号:30970988);重庆市科技惠民计划资助项目(编号:cstc2013jcsf B10001-2)

摘　　要：目的:分析神经内科门诊丛集性头痛(cluster headache,CH)的临床特征及其治疗。方法:回顾性分析2013年9月至2015年11月我院神经内科门诊CH患者的人口学特征和临床特点,电话回访患者的用药治疗情况。结果:一共收录32例患者,患者平均发病年龄为29.6岁,男女患病比例为1.9:1(男21例,女11例),初次起病到被确诊的平均时间为10.6年。93.8%的患者有有自主神经症状,其中最常见的是头痛同侧流泪(75.0%)。恶心、呕吐、畏光和畏声为较常见的伴随症状,分别占56.3%、28.1%、37.5%和53.1%。所有的患者均为发作性丛集性头痛(episodic cluster headache,ECH),不存在慢性丛集性头痛(chronic cluster headache,CCH)。在头痛前或头痛中均无先兆症状。在本研究中共有21例患者在急性治疗中口服苯甲酸利扎曲普坦,其中13例(61.9%)有效;共有15例患者在预防性治疗中口服泼尼松片,其中12例(80.0%)有效。此外还有7例患者使用维拉帕米作为预防性治疗药物,共有4例(57.1%)有效。结论:和西方国家相比,我国CH患者初次起病到被确诊的时间更长,有待提高医生对CH的认识。Objective：To analyze the clinical characteristics of cluster headache （CH）. Methods：Retrospective analysis of 32 patients with CH referred to the neurological clinic from September 2013 to November 2015 in the First Affiliated Hospital of Chongqing Medical was made. Data of demographic and clinical characteristics of these patients were investigated. The information of treatment was collected through follow-up phone calls. Results：Of the 32 CH patients,21 are males and 11 are females（male ：female=l.9：l ）, with the average age of 29.6 years at onset. The mean latency was 10.6 years before diagnosis. Cranial autonomic features were pre- sented in 93.8% patients, and lacrimation （75.0%） was the most common one. Nausea （56.3%）, vomiting （28.1% ）, photophobia （37.5%） and phonophobia （53.1%） may accompany CH. All patients were diagnosed to have episodic cluster headache （ECH）, while chronic cluster headache （CCH） was absent. Before or during attacks, no patients had aura symptom. Twenty-one CH patients used rizatriptan benzoate for acute cluster attacks and 61.9 % reported effective. For preventive therapy, 15 CH patients used pred- nisolone tablets and 7 patients used verapamil; 80.0 % and 57.1% reported to be effective respectively. Conclusion：The mean la- tency of CH is longer in China than in western countries, so clinicians shouid pay more attention to the diagnosis of CH.

关 键 词：丛集性头痛 临床特征 延迟诊断 治疗 

分 类 号：R747.2[医药卫生—神经病学与精神病学]