Tzourio C, Tehindrazanarivelo A, Iglésias S, Alpérovitch A, Chedru F, d'Anglejan-Chatillon J, Bousser M G
INSERM U 360, Recherches Epidémiologiques en Neurologie et Psychopathologie, Villejuif, France.
BMJ. 1995 Apr 1;310(6983):830-3. doi: 10.1136/bmj.310.6983.830.
To determine whether migraine is a risk factor for ischaemic stroke in young women.
A case-control study.
Five hospitals in Paris and suburbs.
72 women aged under 45 with ischaemic stroke and 173 controls randomly selected from women hospitalised in the same centres.
Ischaemic stroke confirmed by cerebral computerised tomography or magnetic resonance imaging; history of headache recorded with structured interview, and diagnosis of migraine assessed by reproducibility study.
Ischaemic stroke was strongly associated with migraine, both migraine without aura (odds ratio 3.0 (95% confidence interval 1.5 to 5.8)) and migraine with aura (odds ratio 6.2 (2.1 to 18.0)). The risk of ischaemic stroke was substantially increased for migrainous women who were using oral contraceptives (odds ratio 13.9) or who were heavy smokers (> or = 20 cigarettes/day) (odds ratio 10.2).
These results indicate an independent association between migraine and the risk of ischaemic stroke in young women. Although the absolute risk of ischaemic stroke in young women with migraine is low, the reduction of known risk factors for stroke, in particular smoking and use of oral contraceptives, should be considered in this group.
确定偏头痛是否为年轻女性缺血性卒中的危险因素。
病例对照研究。
巴黎及其郊区的五家医院。
72名45岁以下的缺血性卒中女性患者以及173名从同一中心住院女性中随机选取的对照者。
经脑计算机断层扫描或磁共振成像确诊的缺血性卒中；通过结构化访谈记录头痛病史，并通过可重复性研究评估偏头痛诊断。
缺血性卒中与偏头痛密切相关，无先兆偏头痛（比值比3.0（95%置信区间1.5至5.8））和有先兆偏头痛（比值比6.2（2.1至18.0））均如此。正在使用口服避孕药的偏头痛女性（比值比13.9）或重度吸烟者（≥20支/天）（比值比10.2）发生缺血性卒中的风险大幅增加。
这些结果表明偏头痛与年轻女性缺血性卒中风险之间存在独立关联。尽管偏头痛年轻女性发生缺血性卒中的确切风险较低，但该群体应考虑降低已知的卒中危险因素，尤其是吸烟和使用口服避孕药。
