目的 探讨武警某部青年官兵慢性头痛临床特征及严重程度的危险因素。方法 选取2020-01至2023-09在武警湖北总队医院神经内科门诊就诊的某部头痛官兵患者126例,并随机选取同时期来院体检的健康官兵126名作为对照组。分析慢性头痛组的一般临床特征,比较慢性头痛组和对照组的体重指数、睡眠障碍、睡眠时间、焦虑抑郁、总胆固醇、低密度脂蛋白胆固醇及三酰甘油指标。采用有序多元logistic回归分析影响头痛严重程度的危险因素。结果 头痛组平均年龄(26.10±3.49)岁,男104例,女22例,男女比例4.73∶1;慢性头痛官兵以慢性紧张型头痛(42.06%)、慢性偏头痛(30.95%)为主;男性多于女性;头痛部位多为颞部(28.57%);头痛性质以紧箍样或压迫样(40.48%)为主;头痛程度主要为轻度(42.86%)及中度(41.27%)为主;部分官兵因劳累(25.40%)或情绪原因(14.29%)诱发头痛发作。头痛组睡眠障碍和焦虑抑郁发生率均高于对照组(P＜0.01),睡眠时间显著少于对照组(P＜0.05),低密度脂蛋白胆固醇、三酰甘油显著高于对照组(P＜0.05);两组BMI、总胆固醇无统计学差异(P＞0.05)。有序多元logistic回归分析结果显示,睡眠时间(OR=0.484,95%CI:0.266～0.881)、睡眠障碍(OR=3.924,95%CI:1.505～10.232)、家族史阳性(OR=2.779,95%CI:1.003～7.702)、焦虑抑郁(OR=3.644,95%CI:1.026～12.945)为慢性头痛程度的影响因素。结论 青年官兵慢性头痛以慢性紧张性头痛为主,男性居多,主要为紧箍样或压迫样疼痛,轻中度疼痛为主,常伴有睡眠障碍、焦虑抑郁、血脂增高及家族史阳性。
Abstract
Objective To study the clinical features and risk factors of severity of chronic headache in young officers and soldiers of a unit of Chinese People’s Armed Police Force. Methods A total of 126 headache patients admitted to the Neurology Department of Hubei Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2020 to September 2023 were selected, and 126 healthy soldiers who came to the hospital for physical examination during the same period were randomly selected as controls. The general clinical features of the chronic headache group were analyzed, and BMI, sleep disorder, sleep duration, anxiety and depression, total cholesterol, low-density lipoprotein cholesterol, and triglyceride indicators were compared between the two groups.Multiple logistic regression was used to identify the risk factors affecting the severity of headache. Results The average age of the headache group was (26.10±3.49) years old, with 104 males and 22 females, with a male to female ratio of 4.73:1. Chronic headache was mainly characterized by chronic tension-type headache (42.06%) and chronic migraine (30.95%). The disease occurred more often in males than in females. The headache was more often seen in the temporal region (28.57%), and the nature of headache was mainly characterized by tightness or compression (40.48%). The degree of headache was mainly mild (42.86%) and moderate (41.27%). Some officers and soldiers might experience headaches due to fatigue (25.40%) or emotional reasons (14.29%), and the headache group had significantly higher levels of sleep disorder (P＜0.05), significantly shorter sleep time (P＜0.05), more anxiety and depression (P＜0.05), and significantly higher levels of low-density lipoprotein cholesterol and triglyceride (P＜0.05). There was no significant difference in BMI or total cholesterol between the two groups (P>0.05). Ordered multiple logistic regression analysis showed that sleep duration (OR=0.484, 95% CI: 0.266-0.881), sleep disorder (OR=3.924, 95% CI: 1.505-10.232), positive family history (OR=2.779, 95% CI: 1.003-7.702), and anxiety and depression (OR=3.644, 95% CI: 1.026-12.945) were the influencing factors for the degree of chronic headache. Conclusions Chronic headache in young officers and soldiers is mainly chronic tension pain, with more males involved, mainly tight or compressed suffering, and mainly mild to moderate one, which is often accompanied by sleep disorder, anxiety and depression, elevated blood lipids, and a positive family history.
关键词
慢性头痛 /
临床特征 /
睡眠障碍 /
焦虑抑郁 /
相关因素
Key words
chronic headache /
clinical feature /
sleep disorder /
anxiety and depression /
related factor
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Sheikh H U. Approach to chronic daily headache[J]. Curr Neurol Neurosci Rep,2015,15(3): 4.
[2] 邢翔皓,黄 燕,张剑铎,等. 海军某部慢性疼痛官兵心理灵活性现状及其影响因素[J]. 中华航海医学与高气压医学杂志,2021,28(4): 417-420, 424.
[3] Silberstein S D,Lipton R B,Solomon S,et al. Classification of daily and near-daily headache: proposed revisions to the HIS criteria [J]. Headache,1994, 34(1): 1-7.
[4] Stark R J, Ravishankar K, Show H C, et al. Chronic migraine and chronic in the Asia-Pacific region: a systematic review [J]. Cephalalgia, 2013, 33 (4): 266-283.
[5] Natoli J L,Manack A,Dean B. Global prevalence of chronic migraine: a systematic review [J]. Cephalalgia, 2010, 30 (5): 599-609.
[6] Rezaeian S, Hamzeh B, Darbandi M, et al. Factors associated with chronic headache among adults: results from a Ravansar noncommunicable disease cohort study[J]. East Mediterr Health J, 2023, 29(8): 620-629.
[7] 代瑞红,廖晓阳.失眠与紧张性头痛及其诱因间关系的研究进展[J]. 中国全科医学,2020,23(36):4615-4618.
[8] 张紫昊,李一鸣,张道培,等. 饮食和偏头痛的关系:诱发与治疗[J]. 中华神经医学杂志,2023, 22(11):1169-1174.
[9] 王 栋. 偏头痛诱发因素与遗传[J]. 国际神经病学神经外科学杂志, 2019, 46(1):113-117.
[10] 陈柯言,史兆春,万 琪. 慢性头痛与睡眠障碍的研究进展[J]. 江苏医药, 2017, 43(8): 582-585.
[11] Guidetti V, Dosi C,Bruni O. The relationship between sleep and headache in children: implications for treatment[J]. Cephalalgia,2014,34: 767.
[12] Miyamoto M,Suzuki K,Miyamoto T,et al. Headache and sleep disorders[J]. Rinsho Shinkeigaku, 2014, 54: 991-993.
[13] Staner L. Comorbidity of insomnia and depression [J]. Sleep Med Rev,2010,14(1):35-46.
[14] Palacios-cena M,Fernandez-Munoz J J,Castaldo M,et al.The association of headache frequency with pain interference and the burden of disease is mediated by depression and sleep quality,but not anxiety,in chronic tension type headache[J]. J Headache Pain,2017,18:19.
[15] Cho S J, Chu M K. Risk factors of chronic daily headache or chronic migraine[J]. Curr Pain Headache Rep, 2015, 19: 465.
[16] 张中菊,杨 丽. 偏头痛患者内皮素-1与血脂异常的相关性研究[J]. 中国现代神经疾病杂志,2013,13(9): 783-786.
[17] Saberi A, Hatamian H R, Kazemnejad E, et al. Hyperlipidemia in migraine: is it more frequent in migraineurs?[J]. Iranian J Neurol, 2011, 10(3-4): 46-50.
[18] Ulusoy E K. Correlations between the monocyte to high-density lipoprotein cholesterol ratio and white matter hyperintensities in migraine[J]. Neurological Res, 2020, 42(2): 126-32.
[19] Naughton F, Ashworth P, Skevington S M. Does sleep quality predict pain-related disability in chronic pain patients? The mediating roles of depression and pain severity[J]. Pain, 2007, 127(3): 243-252.
[20] Rissling M B, Gray K E, Ulmer C S, et al. Sleep disturbance, diabetes, and cardiovascular disease in postmenopausal veteran women[J]. Gerontologist, 2016, 56(Suppl1): S54-66.
[21] 李华文,邹良达,周映彤,等. 神经性头痛患者疼痛程度与抑郁焦虑情绪评分的关系研究[J]. 中国医学创新,2020,17(36): 144-147.
[22] 杨怡尧,赵红如,陆海峰,等. 慢性偏头痛患者头痛影响和残疾程度分析[J]. 实用医学杂志,2018,34(24): 4093-4097.
[23] 付维亮. 工作与头痛——头痛严重程度的心理、社会、劳动强度预测指标的前瞻性研究[J]. 中国疼痛医学杂志,2013,19(1): 29-30.
PDF(945 KB)
