原发性阵发性偏侧头痛临床特征分析与ICHD-Ⅲ beta诊断标准测试  

Clinical features of primary paroxysmal hemicrania and clinical test of diagnostic criteria in ICHD-Ⅲ beta

作　　者：黎伦晞 陈津津[1] 张艺馨[1] 王奎云[1] 廖琦[1] 邓勇[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1262-1266,共5页Journal of Chongqing Medical University

基　　金：重庆市科委集成示范计划(科技惠民)项目(编号:cstc2013jcsf B10001-2)

摘　　要：目的:研究原发性阵发性偏侧头痛(paroxysmal hemicrania,PH)的临床特征,并对国际头痛疾病分类第三版试行版(International Classification of Headache Disorders,3rd Edition,beta version,ICHD-Ⅲbeta)中阵发性偏侧头痛的诊断标准进行临床实践测试。方法:参照ICHD-Ⅲbeta诊断标准,3648例以头痛为主诉的头痛门诊患者中,10例诊断为PH,对其人口学特征以及临床特征进行分析。结果:PH起病年龄为(40.40±12.77)岁,男性5例(50%),女性5例(50%)。10例患者亚型全为发作性阵发性偏侧头痛(100%),头痛发作部位最常见于颞部(80%)和眼眶(50%),最常见的自主神经症状症状为同侧眼部充血、流泪、水肿(70%);患者均为中重度疼痛,以跳痛最为常见。头痛发作持续时间基本在2~30 min以内,但有40%的患者曾出现不满足PH诊断标准中的B标准的情况。发作期一半以上的天数头痛发作频率均在5次/d以上。对吲哚美辛治疗的反应良好。结论:头痛门诊中PH患者的临床特征与国外的报道相似,但以EPH的发病率较高,与国外CPH为主的发病特征有差异。PH的诊断标准(ICHD-Ⅲbeta)基本符合临床运用实践,新增的两个可能伴随症状均有临床意义。但仍需进一步改进,如头痛发作时长的规定。Objectives ：To study the clinical features of paroxysmal hemicrania（PH） and to test the diagnostic criteria of the Interna- tional Classification of Headache Disorders, 3rd Edition （beta version）. Methods：All 3648 patients with headache participated in the research, and 10 of them were diagnosed as PH according to the diagnostic criteria in ICHD-Ⅲ beta. The demographic characteristics and clinical features of these patients were analyzed. Results：The mean onset age of hemicrania was （40.40 ± 12.77） years,and the male-female ratio was 1：1. All the 10 patients were episodic paroxysmal hemicrania（ 100%）;the most common locations of hemicra- nia were temple （80%） and orbit （50%）. The most common cranial autonomic features were ipsilateral conjunctival injection and/or lacrimation or edema. All the patients described their pain as ＂moderate＂ or ＂severe＂, and the most common characteristic of the pain was throbbing. The duration of patients who had attacks was 2-30 min,however,40% of patients could not meet criteria B. All the pa- tients suffered from more than 5 attacks per day. Moreover, the response to therapy of indomethacin was quite well. Conclusion：Our patients have similar clinical symptoms as those in western studies. The majority of our patients are diagnosed as EPH while CPH had a higher morbidity in foreign studies. PH diagnostic criteria in ICHD-Ⅲ beta might be further modified, such as the attack duration of hemicrania.

关 键 词：阵发性偏侧头痛 临床特征 国际头痛疾病分类第三版试行版 临床测试 

分 类 号：R747.2[医药卫生—神经病学与精神病学]