偏头痛作为亚临床脑病变的危险因素
Mark C Kruit1, Mark A van Buchem, Paul A M Hofman
1Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. m.c.kruit@lumc.nl
JAMA
|January 30, 2004
概括
偏头痛患者,特别是那些有光环和频繁发作的人,患上后部循环中风和深白质病变 (DWMLs) 的风险更高. 这项以人口为基础的研究强调了偏头痛和亚临床大脑病变之间的潜在联系.
科学领域:
- 神经学 神经学
- 神经成像是一种神经成像.
- 流行病学 流行病学
背景情况:
- 之前的临床研究表明,偏头痛患者中脑梗塞和白质病变 (WMLs) 的患病率较高.
- 这些脑病变在普通偏头痛患者中发生的情况在很大程度上是未知的.
研究的目的:
- 为了比较脑梗塞和WML在普通人口样本中偏头痛患者与对照者的患病率.
- 确定与这些脑病变风险增加相关的特定偏头痛特征.
主要方法:
- 一项基于人口的横截面流行研究,涉及30至60岁的荷兰成年人.
- 包括随机选择的患有带有光环的偏头痛 (n=161),没有光环的偏头痛 (n=134) 和匹配的对照组 (n=140) 的患者.
- 磁共振成像 (MRI) 用于评估心脏病发作和WMLs (周心室和深层),分析因心血管风险因素而调整的几率比率.
主要成果:
- 在偏头痛患者和对照人群之间,整体心脏病发病率没有显著差异 (8.1%对5.0%).
- 在偏头痛患者 (5.4%对0.7%) 中,小脑区域 (后部循环区域) 观察到显著更高的中风发病率.
- 后部心脏病发作的风险增加与偏头痛与光环 (OR 13.7) 和频繁发作 (≥1/月,OR 9.3) 相关,特别是在具有高深层WML负载的女性 (OR 2.1,随着发作频率增加) 中.
结论:
- 基于人群的发现表明,在某些偏头痛患者亚组中,特定的亚临床脑病变,特别是后部心脏病发作和深部WML的风险增加.
- 带有光环的偏头痛和频繁的发作与较高的后部循环心脏病发作风险有关.
- 患有偏头痛的女性患深层WML的风险增加,这与发作频率相关.
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