药物过度使用性头痛：一项4年前瞻性研究中的复发率及预测因素

Medication overuse headache: rates and predictors for relapse in a 4-year prospective study.

作者信息

Katsarava Z, Muessig M, Dzagnidze A, Fritsche G, Diener H C, Limmroth V

机构信息

Department of Neurology, University Hospital Essen, Essen, Germany.

出版信息

Cephalalgia. 2005 Jan;25(1):12-5. doi: 10.1111/j.1468-2982.2004.00789.x.

DOI:10.1111/j.1468-2982.2004.00789.x

PMID:15606564

Abstract

We present a prospective 4-year follow-up study of 96 patients with medication overuse headache following withdrawal. Complete datasets were available from 85 patients (89%) 6 months, from 79 patients (82%) 1 year and from 75 patients (78%) 4 years after withdrawal. Twenty-six patients (31%) relapsed within the first 6 months after withdrawal. The number of relapses increased to 32 (41%) 1 year and to 34 (45%) 4 years after withdrawal. The 4-year relapse rate was lower in migraine than in tension-type headache (32% vs. 91%, P<or=0.001) and combination of migraine and tension-type headache (32% vs. 70%, P<or=0.027) and also lower in patients overusing triptans than analgesics (21% vs. 71%, P<or=0.001). The study suggests that the majority of relapses occur within the first year after withdrawal and that the long-term success of withdrawal depends on the type of primary headache and the type of overused medication.

摘要

我们对96例药物过量使用性头痛患者戒断后进行了为期4年的前瞻性随访研究。在戒断后6个月，85例患者（89%）、1年时79例患者（82%）以及4年时75例患者（78%）可获得完整数据集。26例患者（31%）在戒断后的前6个月内复发。复发人数在戒断后1年增加至32例（41%），4年时增加至34例（45%）。偏头痛患者的4年复发率低于紧张型头痛患者（32%对91%，P≤0.001）以及偏头痛与紧张型头痛合并患者（32%对70%，P≤0.027），并且过度使用曲坦类药物的患者低于使用镇痛药的患者（21%对71%，P≤0.001）。该研究表明，大多数复发发生在戒断后的第一年内，且戒断的长期成功率取决于原发性头痛的类型以及过度使用药物的类型。