哮喘患者中头痛和偏头痛的存在情况。
Presence of Headache and Migraine in Asthma Patients.
作者信息
Turan Muzaffer Onur, Susuz Çiğdem Çelik, Turan Pakize Ayşe
机构信息
Department of Chest Diseases, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey.
Clinic of Neurology, Afyonkarahisar State Hospital, Afyon, Turkey.
出版信息
Turk Thorac J. 2017 Apr;18(2):47-51. doi: 10.5152/TurkThoracJ.2017.16008. Epub 2017 Apr 1.
OBJECTIVES
Migraine is a diseases characterized with severe headaches, with neurological and systemic findings. The purpose of this study is to investigate the prevalence of migraine and to examine whether there is a relationship between atopic disorders, parental history and migraine in asthma patients.
MATERIAL AND METHODS
A total of 288 asthma outpatients, who had the diagnosis by an early or late test of reversibility showing a reversible airway obstruction according to hospital database were included. The presence of headache, atopic symptoms and parental history about asthma, atopic disorders and migraine were asked. The patients with headache were consultated by neurology department and investigated about the presence of migraine. The diagnosis of migraine headache was made if patients fulfilled the International Headache Society (IHS) criteria.
RESULTS
60.4% of patients described a headache. There were 94 patients (32.6%) with headaches meeting the IHS criteria for migraine. Only 12 patients had migraine with aura. There were atopic symptoms in 86.8% of patients. According to parental history, there were asthma in 47.9%, atopic symptoms in 39.6% and migraine in 22.2% of parents. Patients with atopic symptoms were found to have significantly high rate of headaches (65.3%) "p=0.007". The prevalence of migraine was significantly high in patients with parental atopic symptoms (54%) "p=0.002". Multiple logistic regression analysis identified that gender, parental history of asthma, allergia and migraine, and smoking were independent risk factors for presence of migraine in asthmatics.
CONCLUSION
There is a high prevalence of migraine headaches in patients with asthma. The coexistence of asthma and headaches may be related with a similar pathophysiological mechanism; parental history, common genetic compounds and smoking may play role in this mechanism. The headaches in asthma patients, atopic symptoms and family history should be questioned, and clinicians should be careful about the presence of migraine.
目的
偏头痛是一种以严重头痛为特征，并伴有神经和全身症状的疾病。本研究旨在调查偏头痛的患病率，并探讨哮喘患者中特应性疾病、家族史与偏头痛之间是否存在关联。
材料与方法
根据医院数据库，纳入了288例经早期或晚期可逆性试验确诊为可逆性气道阻塞的哮喘门诊患者。询问了头痛、特应性症状以及关于哮喘、特应性疾病和偏头痛的家族史。有头痛症状的患者由神经科会诊，以调查是否存在偏头痛。如果患者符合国际头痛协会（IHS）标准，则诊断为偏头痛性头痛。
结果
60.4%的患者描述有头痛症状。有94例（32.6%）头痛患者符合IHS偏头痛标准。只有12例患者有先兆偏头痛。86.8%的患者有特应性症状。根据家族史，父母中有哮喘的占47.9%，有特应性症状的占39.6%，有偏头痛的占22.2%。发现有特应性症状的患者头痛发生率显著较高（65.3%），“p = 0.007”。有父母特应性症状的患者偏头痛患病率显著较高（54%），“p = 0.002”。多因素逻辑回归分析确定，性别、父母哮喘家族史、过敏和偏头痛以及吸烟是哮喘患者偏头痛发生的独立危险因素。
结论
哮喘患者中偏头痛性头痛的患病率较高。哮喘和头痛并存可能与相似的病理生理机制有关；家族史、共同的遗传因素和吸烟可能在这一机制中起作用。应询问哮喘患者的头痛情况、特应性症状和家族史，临床医生应留意偏头痛的存在。
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