老年中国人缺血性中风与偏头痛的关联：一项病例对照研究。
Association between ischemic stroke and migraine in elderly Chinese: a case-control study.
机构信息
Department of Neurology, Municipal Hospital of Taizhou, Jiaojiang, Zhejiang 318000, China.
出版信息
BMC Geriatr. 2013 Nov 19;13:126. doi: 10.1186/1471-2318-13-126.
BACKGROUND
Recent observations suggest that migraine and cerebrovascular disease are comorbid conditions. However, the association of migraine with cerebrovascular disease in the population of elderly Chinese has not been established. This prospective case-control study aimed to investigate the prevalence and lesion characteristics of migraine in elderly Chinese patients with acute cerebral infarction (ACI).
METHODS
A total of 968 ACI patients aged 55-70 years and 1024 sex- and age-matched control subjects were recruited between January, 2003 and July, 2009. Migraine was determined based on the International Headache Society's Classification of Headache Disorders, together with past medical records and admission examination results, following an initial questionnaire screening at the first hospital visit. Prevalence rates of overall migraine, migraine with aura and migraine without aura in both ACI patients and control subjects, the stroke subtypes classified according to the Chinese Ischemic Stroke Subclassification (CISS) system and brain locations of the ischemic lesions in ACI patients were analyzed.
RESULTS
The overall prevalence rate of migraine was 17.15% (166/968) in patients with ACI but only 3.9% (40/1024) in control subjects (P < 0.01). In both subject groups, over 80% of migraine cases were migraine without aura. In the 166 ACI patients with comorbid migraine, large artery atherosclerosis was the most frequent subtype of ischemic lesion (65.06%), followed by cardiogenic stroke (23.50%), and all other lesion subtypes were each less than 10%. Ischemic infarctions were located predominantly in the anterior circulation in the brain in both ACI patients with and without migraine.
CONCLUSIONS
The prevalence rate of migraine is significantly higher in ACI patients than non-ACI subjects in the population of elderly Chinese. Migraine without aura is the major form of migraine in both ACI patients and non-ACI subjects. In ACI patients, regardless of migraine, infarction lesions were predominantly located in the anterior cerebral circulation.
背景
最近的观察结果表明，偏头痛和脑血管疾病是并存的疾病。然而，偏头痛与中国老年人群中脑血管疾病的关联尚未确定。本前瞻性病例对照研究旨在探讨老年中国急性脑梗死（ACI）患者偏头痛的患病率和病变特征。
方法
2003 年 1 月至 2009 年 7 月期间，共招募了 968 名年龄在 55-70 岁的 ACI 患者和 1024 名性别和年龄匹配的对照组。根据国际头痛协会的头痛疾病分类，结合既往病历和入院检查结果，在首次就诊时进行初步问卷调查筛查，确定偏头痛。分析 ACI 患者和对照组中偏头痛的总体患病率、有先兆偏头痛和无先兆偏头痛、根据中国缺血性卒中亚型分类（CISS）系统分类的卒中亚型以及 ACI 患者的缺血性病变部位。
结果
ACI 患者偏头痛的总体患病率为 17.15%（166/968），而对照组仅为 3.9%（40/1024）（P<0.01）。在两组受试者中，超过 80%的偏头痛病例为无先兆偏头痛。在 166 例伴有偏头痛的 ACI 患者中，大血管粥样硬化是最常见的缺血性病变类型（65.06%），其次是心源性卒中（23.50%），所有其他病变类型均少于 10%。无论是否患有偏头痛，ACI 患者的缺血性梗死均主要位于大脑前循环。
结论
在中国老年人群中，偏头痛在 ACI 患者中的患病率明显高于非 ACI 患者。无先兆偏头痛是 ACI 患者和非 ACI 患者中偏头痛的主要形式。在 ACI 患者中，无论是否患有偏头痛，梗死病灶主要位于前循环。
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