Benedick Aviv, Zeharia Avraham, Markus Tal Eidlitz
Day Hospitalization Department, Pediatric Headache Clinic, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Child Neurol. 2019 Nov;34(13):824-829. doi: 10.1177/0883073819862738. Epub 2019 Jul 18.
Hypercoagulability may explain the increased risk of thromboembolic cerebrovascular events in patients with migraine. Thrombocytes play a crucial part in the coagulation process, and some studies have demonstrated hyperaggregation of thrombocytes in adult migraineurs. We aimed to compare thrombocyte count between pediatric patients with migraine or tension-type headache and to evaluate the correlation of thrombocyte count with headache parameters. The electronic database of a tertiary pediatric headache clinic was retrospectively searched for all children and adolescents diagnosed with migraine or tension-type headache in 2016-2018. Data on thrombocyte counts were collected from the medical files and compared between the groups by parametric and nonparametric statistical tests. The cohort included 299 patients, 176 girls (59.0%) and 123 (412.0%) boys, of mean age 12.2 ± 3.4 years; 198 had migraine and 101 had tension-type headache. Among the laboratory parameters evaluated, a significantly lower mean thrombocyte number was found in the migraine group than in the tension-type headache group (282 ± 60 vs 304±71 ×10/μL, = .004). Within the migraine group, there was a significant negative correlation between the thrombocyte count and the duration of headache attacks in hours ( < .05). No significant between- or within-group differences were found in other laboratory parameters. The low relative thrombocyte count in pediatric headache clinic patients with migraine and its negative correlation with duration of migraine suggest that migraine may be associated with a different underlying pathogenesis from tension-type headache.
高凝状态可能解释偏头痛患者血栓栓塞性脑血管事件风险增加的原因。血小板在凝血过程中起关键作用，一些研究已证实在成年偏头痛患者中血小板存在高聚集现象。我们旨在比较偏头痛或紧张型头痛儿科患者的血小板计数，并评估血小板计数与头痛参数之间的相关性。对一家三级儿科头痛诊所的电子数据库进行回顾性检索，以查找2016 - 2018年期间所有诊断为偏头痛或紧张型头痛的儿童和青少年。从病历中收集血小板计数数据，并通过参数和非参数统计检验在各组之间进行比较。该队列包括299名患者，其中176名女孩（59.0%）和123名男孩（41.0%），平均年龄12.2±3.4岁；198人患有偏头痛，101人患有紧张型头痛。在所评估的实验室参数中，偏头痛组的平均血小板数量显著低于紧张型头痛组（282±60 vs 304±71×10⁹/μL，P = 0.004）。在偏头痛组中，血小板计数与以小时为单位的头痛发作持续时间之间存在显著负相关（P < 0.05）。在其他实验室参数方面，未发现组间或组内有显著差异。儿科头痛诊所中偏头痛患者的相对血小板计数较低及其与偏头痛持续时间的负相关表明，偏头痛可能与紧张型头痛具有不同的潜在发病机制。
