偏头痛患者前庭症状与头痛相关性的临床研究  

Correlation of vestibular symptoms and headache in migraine patients:a clinical study of 424 cases

作　　者：刘娟[1] 潘琪 张芸 范玉兰[1] 范小平[1] 张艺馨[1] 周冀英[1] LIU Juan;PAN Qi;ZHANG Yun;FAN Yulan;FAN Xiaoping;ZHANG Yixin;ZHOU Jiying(Department of Neurology,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)

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：《第三军医大学学报》2021年第8期700-706,共7页Journal of Third Military Medical University

基　　金：国家自然科学基金面上项目(81971063);重庆市卫计委-卫生适宜技术推广项目(2018jstg045)。

摘　　要：目的评估偏头痛患者中前庭症状与头痛的相关性,探讨前庭症状在偏头痛中的诊断应用价值。方法连续性纳入2019年1-12月首次就诊于我科门诊以头痛为主诉的患者,将诊断符合国际头痛分类第3版(International Classification of Headache Disorders,3rd edition,ICHD-3)的原发性头痛患者分为发作性偏头痛组、慢性偏头痛组、紧张型头痛组,将发作性偏头痛患者分为低频、中频及高频组,以半结构型问卷收集临床症状,前庭症状采用前庭性偏头痛中前庭症状的标准。结果共纳入424例,发作性偏头痛组222例,慢性偏头痛组174例,紧张型头痛组28例。前庭症状在偏头痛组及紧张型头痛组中占比分别为25.3%和3.6%,慢性偏头痛组中前庭症状出现的频率(31.0%)高于发作性偏头痛组(20.7%)(P=0.019)。将发作性偏头痛患者分成低频、中频及高频组,中频组(头痛频率在2~8 d/月)的人数最多(125/222),且头痛特点及伴随症状最典型。前庭症状与头痛发生的时间相关性中,低频头痛组有68.8%的患者头痛与前庭症状分开发作,高频头痛组和慢性偏头痛组头痛与前庭症状同时发作占比高于低频组(P<0.05)。结论前庭症状在慢性偏头痛患者中出现频率高,提示前庭症状可能与偏头痛的慢性化相关。Objective To evaluate the correlation between vestibular symptoms and headache in patients with migraine,and to explore the diagnostic value of vestibular symptoms in migraine.Methods Consecutive patients who visited our outpatient department of neurology due to a principal complaint of headache during January to December 2019 were recruited in this study.According to the International Classification of Headache Disorders,3 rd edition(ICHD-3),these patients with primary headache were divided into the episodic migraine group,chronic migraine group and tension-type headache group,and those with episodic migraine were assigned into low-,medium-and high-frequency groups.A semi-structured questionnaire was used to collect their information on the clinical symptoms.The vestibular symptoms were identified according to the standard of vestibular symptoms in vestibular migraine.Results There were 424 patients recruited,including 222 in the episodic migraine group,174 in the chronic migraine group and 28 in the tension-type headache group.Vestibular symptoms accounted for 25.3%and 3.6%in the migraine group and tension-type headache group,respectively.The frequency of vestibular symptoms was higher in the chronic migraine group(31.0%)than the episodic migraine group(20.7%)(P=0.019).The medium-frequency group(with a headache frequency of 2~8 d per month)had the largest number of patients(125/222),with most typical migraine features and accompanying symptoms.In the time correlation between vestibular symptoms and headache,68.8%of the patients in the low-frequency group had separate attacks of headache and vestibular symptoms.The simultaneous attack of headache and vestibular symptoms was higher in the high-frequency group and the chronic migraine group than the low-frequency group(P<0.05).Conclusion Vestibular symptoms occur frequently in patients with chronic migraine,suggesting that vestibular symptoms may be associated with the chronicity of migraine.

关 键 词：发作性偏头痛 慢性偏头痛 前庭症状 

分 类 号：R181.32[医药卫生—流行病学] R441.2[医药卫生—公共卫生与预防医学]