新的伴有先兆偏头痛国际分类(ICHD - 2)应用于362例偏头痛患者。

New international classification of migraine with aura (ICHD-2) applied to 362 migraine patients.

作者信息

Eriksen M K, Thomsen L L, Olesen J

机构信息

Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.

出版信息

Eur J Neurol. 2004 Sep;11(9):583-91. doi: 10.1111/j.1468-1331.2004.00890.x.

Abstract

The International Classification of Headache Disorders 2nd edition (ICHD-2) subdivides migraine with aura (MA) differently from the ICHD-1 and includes new diagnostic criteria. The aim of the present study was to evaluate how the new classification works in practice and in comparison with the ICHD-1. The patients were recruited from a screen of the Danish National Patient Registry and from Danish neurologists. We included 362 patients diagnosed with MA according to the ICHD-1 in a validated semistructured physician-conducted interview. According to the ICHD-2, 89% (322 of 362) had MA and 11% (40 of 362) had probable MA. The MA patients had one or more ICHD-2 subtype of MA: 54% (173 of 322) had typical aura with migraine headache (MA-MH), 40% (129 of 322) had typical aura with non-migraine headache (MA-NMH), 37% (120 of 322) had aura without headache (MA-WOH), and 7% (26 of 322) had basilar-type migraine (MA-B). Of patients with MA-MH 34% (59 of 173) had co-occurrence of MA-WOH, 9% (16 of 173) had co-occurrence of MA-B and 5% (8 of 173) had co-occurrence of both MA-WOH and MA-B. Of patients with MA-NMH 27% (35 of 129) had co-occurrence of MA-WOH. Only 6% (18 of 322) of the MA patients had exclusively MA-WOH and <1% (2 of 322) had exclusively MA-B. Patients with MA-MH had an earlier age at onset (P = 0.044), an increased lifetime number of MA attacks (P = 0.054) and a higher co-occurrence of migraine without aura (P = 0.002) than patients with MA-NMH. Patients with MA-B tended to have an earlier age at onset and more severe attacks and patients with MA-WOH had a higher age at onset and less severe attacks than patients with MA-MH. The variations between ICHD-2 subtypes of MA indicate that patients with similar subtype of MA share phenotype and very likely have similar underlying aetiology.

摘要

《国际头痛疾病分类》第二版(ICHD - 2)对伴先兆偏头痛(MA)的细分与ICHD - 1不同,且包含了新的诊断标准。本研究的目的是评估新分类在实际应用中的效果,并与ICHD - 1进行比较。患者从丹麦国家患者登记系统筛选以及丹麦神经科医生处招募。我们纳入了362例根据ICHD - 1诊断为MA的患者,进行了经过验证的半结构化医生访谈。根据ICHD - 2,89%(362例中的322例)为MA,11%(362例中的40例)为可能的MA。MA患者有一种或多种ICHD - 2的MA亚型:54%(322例中的173例)有典型先兆伴偏头痛性头痛(MA - MH),40%(322例中的129例)有典型先兆伴非偏头痛性头痛(MA - NMH),37%(322例中的120例)有无头痛性先兆(MA - WOH),7%(322例中的26例)有基底型偏头痛(MA - B)。在MA - MH患者中,34%(173例中的59例)同时存在MA - WOH,9%(173例中的16例)同时存在MA - B,5%(173例中的8例)同时存在MA - WOH和MA - B。在MA - NMH患者中,27%(129例中的35例)同时存在MA - WOH。MA患者中仅6%(322例中的18例)仅有MA - WOH,<1%(322例中的2例)仅有MA - B。与MA - NMH患者相比,MA - MH患者发病年龄更早(P = 0.044),MA发作的终生次数更多(P = 0.054),无先兆偏头痛的共病率更高(P = 0.002)。与MA - MH患者相比,MA - B患者发病年龄往往更早且发作更严重,MA - WOH患者发病年龄更高且发作较轻。MA的ICHD - 2亚型之间的差异表明,MA亚型相似的患者具有共同的表型,并且很可能具有相似的潜在病因。

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