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儿童期起病头痛的长期转归:一项前瞻性社区研究。

Long term outcome of childhood onset headache: A prospective community study.

机构信息

1 Department of Child Neurology, University of Turku, Turku, Finland.

2 Department of General Practice, University of Turku, Turku, Finland.

出版信息

Cephalalgia. 2018 May;38(6):1159-1166. doi: 10.1177/0333102417727536. Epub 2017 Aug 22.

Abstract

Purpose To examine prevalence, course, and long-term outcome of childhood migraine and other headaches. Method Using questionnaires, 1185 children were followed for recurrent headaches at ages seven, 14 and 32 years, respectively. Results At age seven years, 4.0% of the 1185 children (girls 3.7%, boys 4.3%) had migraine and 24% (25%/23%) had nonmigrainous headache. In adulthood, 16% (22%/8%) had migraine and 60% (64%/54%) nonmigrainous headache. Childhood migraine persisted into adulthood in 65% of females and 21% of males, and nonmigrainous headache in 62% and 59%, respectively. After childhood, 17% of females and 7% of males started to have episodes of migraine. No recurrent headache during the follow-up was reported by 11% (6%/16%). In a multivariate analysis, compared with no childhood headache, childhood migraine increased the risk of adulthood migraine by 3.36-fold (95% CI 1.94-5.82) and that of nonmigrainous headache by 1.72-fold (1.14-2.60). Discussion and conclusions Headaches are generally as common in preschool girls as boys. From early school years, headaches steadily increase up to young adulthood, but among boys the prevalence levels off after adolescence. About two thirds of children experienced changes in their headache status during a 25-year follow-up. Any kind of recurrent headache at school entry predicts an increased risk of headache in young adulthood. Special attention should be paid to girls and particularly those girls who have recurrent headache when they start school.

摘要

目的

研究儿童偏头痛和其他头痛的患病率、病程和长期结局。

方法

使用问卷调查,对 1185 名儿童分别在 7 岁、14 岁和 32 岁时进行复发性头痛随访。

结果

7 岁时,1185 名儿童中有 4.0%(女孩 3.7%,男孩 4.3%)患有偏头痛,24%(25%/23%)患有非偏头痛性头痛。成年时,16%(22%/8%)患有偏头痛,60%(64%/54%)患有非偏头痛性头痛。女性中,65%的儿童偏头痛持续到成年,21%的男性持续到成年;女性中,62%的非偏头痛性头痛持续到成年,59%的男性持续到成年。在儿童期后,17%的女性和 7%的男性开始出现偏头痛发作。11%(6%/16%)的儿童在随访期间没有反复发作的头痛。多变量分析显示,与无儿童期头痛相比,儿童期偏头痛使成年期偏头痛的风险增加 3.36 倍(95%CI 1.94-5.82),非偏头痛性头痛的风险增加 1.72 倍(1.14-2.60)。

讨论和结论

学前女孩和男孩的头痛发生率大致相同。从学龄早期开始,头痛逐渐增加,直到青少年期,但男孩在青春期后发病率趋于平稳。在 25 年的随访中,大约三分之二的儿童经历了头痛状况的变化。任何类型的在校期间反复发作的头痛都预示着在青年期发生头痛的风险增加。应特别关注女孩,特别是那些开始上学时就有反复发作头痛的女孩。

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