偏头痛多种危险因素的分析

目的：研究偏头痛的危险因素。方法：用1：1配对对照的方法进行单因素分析,再用Mc Nemar‘s test公式计算卡方,求得P值,并计算相对危险度。结果：家族遗传史、过敏性疾病史,在病例组与对照间有非常 显著性;睡眠不足、夜间工作,病例组与对照组间有显著性差异。结论：家族遗传史、过敏性疾病史是偏头痛的危险因素。     

发作性偏头痛慢性转化的危险因素分析

目的:比较发作性偏头痛和慢性偏头痛的病史特征,寻找发作性偏头痛慢性转换的危险因素.方法:依据国际头痛学会(IHS)2004年头痛最新分类标准和诊断标准,回顾性分析偏头痛病例149例,其中发作性偏头痛96例,慢性偏头痛53例,首先对观察指标作单因素分析,筛选差异有统计学意义的变量进行前向逐步法Logistic回归分析(α=0.05).结果:Logistic逐步回归筛选出病程(OR=1.067,95% CI 1.016～1.121)、初发头痛频率(OR=1.089,95% CI 1.001～1.185)、匹兹堡睡眠指数(OR=1.352,95% CI 1.169～1.563)、BMI值(OR=3.010,95% CI 1.172～7.730)、镇痛药物过度服用史(OR=3.156,95% CI 1.005～9.967)是影响发作性偏头痛慢性转换的危险因素.结论:积极改善睡眠质量,控制体重,合理用药等,有助于降低发作性偏头痛向慢性偏头痛转化的风险.     

南京鼓楼医院体检人群高血压患病率及相关因素分析

探讨南京市鼓楼医院体检人群高血压的患病率，分析其发病的相关因素。收集2001—03／2001—05在南京市鼓楼医院医院的体检资料，进行标准血压测量，并调查相关危险因素。结果表明有高血压患者的年龄偏大，有配偶者较少，文化程度和平均月收入偏高，脑力劳动者和有高血压家族史较多，平均体质量指数偏大。提示南京市区高血压患者改善不良生活方式、选择合理膳食、加强运动锻炼、调节平衡心态可能有助于高血压的防治。     

江苏省自然人群高血压患病率及相关因素分析

目的：调查江苏省15岁以上自然人群高血压患病率及相关因素。方法：采用分层随机抽样法，对江苏省11市15岁以上8534人进行高血压患病率及相关因素调查分析。结果：江苏省自然人群高血压患病率为19．43％（男性21．27％，女性17．35％），标化患病率为16．65％（男性18．70％，女性15．19％）。单因素分析和多因互logistic回归分析显示与高血压患病相关的危险因素有：年龄、体质指数（BMI）、腰臀围比（WHR）、高血压家族史、血糖、文化程度、婚姻状况、吸烟、饮酒、体力锻炼。结论：高血压是由多基因遗传和多基因遗传和多种环境不良因素交互作用而成。针对高血压的危险因素在人群中开展高血压一级预防具有重要意义。     

偏头痛患者脑白质损害情况及影响因素分析

目的 探讨偏头痛患者脑白质损害情况及影响因素分析.方法 对114例偏头痛患者行磁共振成像、经食道超声心动图及经颅多普勒超声声学造影检查,明确患者脑白质损伤及右向左分流情况,采用单因素及多元Logistic回归分析探讨偏头痛患者脑白质损伤的影响因素.结果 本组114例患者,发生脑白质损伤35例(30.7％),无脑白质损伤...     

科研人员脂肪肝患病率及相关危险因素的分析

目的：探讨科研人员脂肪肝的患病率及其相关危险因素的关系,为科研人员的早期健康管理干预提供依据。方法选取2012年11月在我院体检中心体检的某科研单位具有完整资料的科研工作者445名,根据腹部超声结果分出脂肪肝组与非脂肪肝组,通过性别、年龄分层后比较脂肪肝的患病率,并将脂肪肝患者的体质指数（BMI）、血压、血脂、空腹血糖（FBG）、血尿酸（UA）与非脂肪肝组进行对比分析,对脂肪肝的相关危险因素进行Logistic多因素回归分析。结果（1）共检出脂肪肝73例,总患病率为16.4％,男性与女性患病率接近分别为17.0％与15.0％（ P＞0.05）;男、女脂肪肝患病率随年龄的增加而增加,40～49岁最高达22.3％,但无统计学差异（P＞0.05）。（2）各年龄组脂肪肝的患病率均随着体型的变化（正常、超重、肥胖）依次增加（ P＜0.01）。正常体重组、超重组及肥胖组各年龄段脂肪肝患病率差异无统计学意义（P＞0.05）。（3）单因素分析显示,BMI、血压、血脂、FBG、UA、丙氨酸氨基转移酶（ALT）在脂肪肝组明显高于非脂肪肝组（P均＜0.01）。（4）脂肪肝组的代谢综合征的检出率明显高于非脂肪肝组（43.8％ vs．6.5％,P＜0.001）,脂肪肝组超重、肥胖、血压、FBG、甘油三酯（ TG ）等增高的检出率明显高于非脂肪肝组（ P均＜0.01）。（5）多因素Logistic回归分析提示,脂肪肝危险因素包括性别、血脂异常、UA、超重、肥胖和血压分级（血压正常高值、高血压Ⅰ级、高血压Ⅱ级）,OR值分别为3.445、7.264、1.008、5.642、8.710、（2.228、3.496、3.885）。结论超重、肥胖、血脂异常、高血压、血尿酸水平增高是科研人员脂肪肝发病的主要危险因素,为早期干预脂肪肝的健康管理方案提供重要依据。     

初发脑梗死后失眠患病率及相关因素分析

目的：探讨初发脑梗死后失眠的发病情况及相关影响因素。方法：纳入脑梗死患者150例,采用匹兹堡睡眠质量指数（PSQI）、改良Barthel指数（MBI）、神经功能缺损程度评分（NDS）、汉密尔顿焦虑量表（HAMA）及汉密尔顿抑郁量表（HAMD）进行测评,并以PSQI量表总分〉7分作为判断失眠的标准。分析卒中患者失眠的类型及特点;分析失眠在不同类型人群中发生率的差异,筛选影响因素;分析失眠患者与非失眠患者各量表评分的差异。结果：150例患者中,73例（48.67%）发生失眠,失眠的形式以入睡困难、早醒、睡眠维持困难为主。失眠的发生率与性别、卒中部位、临床神经功能缺损程度、日常生活能力、精神状态关系密切。失眠患者在神经功能缺损程度、焦虑和抑郁程度方面较非失眠患者严重（P〈0.05）,日常生活能力较低（P〈0.05）。结论：初发缺血性脑卒中患者失眠的发生率较高,影响因素有性别、卒中的部位、生活能力、神经功能缺损程度及精神状态。     

中老年男性糖尿病的患病率及相关因素分析

目的：观察中老年男性2型糖尿病的患病率及相关危险因素。方法：40岁以上的男性长住居民2050人。调查项目包括身高、体重、腰围、臀围、血压。测定过夜空腹血糖、甘油三酯、胆固醇、丙氨酸转氨酶。按WHO标准（1997年标准）诊断2型糖尿病。收集资料，输入预先编制的ACCESS数据库，导入SPSS软件。按年龄间隔分组。计数资料用x^2分析，计算资料用t检验，多因素相关回归分析用Logistic统计。结果：①糖尿病的患病率随着年龄的增加而增高（P＜0．01）。②糖尿病患病率与高血压、冠心病呈显著正相关，而与高血压家族史、冠心病家族史和高血脂无明显相关。③发生糖尿病的概率与年龄、腰围、舒张压和分类变量高血压病有无等指标有关。结论：在中老年男性人群中，糖尿病的患病率随着年龄的增加而增高，与高血压、冠心病病史显著相关，与患者的年龄、腰围、舒张压和有无高血压病等显著相关，而与身高、体重、BMI等因素无显著相关。     

江苏省自然人群高血压患病率及相关因素分析

目的 :调查江苏省 15岁以上自然人群高血压患病率及相关因素。方法 :采用分层随机抽样法 ,对江苏省 11市 15岁以上 85 34人进行高血压患病率及相关因素调查分析。结果 :江苏省自然人群高血压患病率为 19 43% (男性 2 1 2 7% ,女性17 35 % ) ,标化患病率为 16 65 % (男性 18 70 % ,女性 15 19% )。单因素分析和多因素logistic回归分析显示与高血压患病相关的危险因素有 :年龄、体质指数 (BMI)、腰臀围比 (WHR)、高血压家族史、血糖、文化程度、婚姻状况、吸烟、饮酒、体力锻炼。结论 :高血压是由多基因遗传和多种环境不良因素交互作用而成。针对高血压的危险因素在人群中开展高血压一级预防具有重要意义     

南京鼓楼医院体检人群高血压患病率及相关因素分析

探讨南京市鼓楼医院体检人群高血压的患病率,分析其发病的相关因素。收集2001-03/2001-05在南京市鼓楼医院医院的体检资料,进行标准血压测量,并调查相关危险因素。结果表明有高血压患者的年龄偏大,有配偶者较少,文化程度和平均月收入偏高,脑力劳动者和有高血压家族史较多,平均体质量指数偏大。提示南京市区高血压患者改善不良生活方式、选择合理膳食、加强运动锻炼、调节平衡心态可能有助于高血压的防治。     

Prospective Analysis of Factors Related to Migraine Aura - The PAMINA Study

Objectives.- The aim of this study was to examine factors increasing and decreasing the risk of occurrence of migraine aura and of headache and migraine not associated with aura (HoA, MoA) prospectively by means of a daily diary. Methods.- Of 327 patients with migraine completing a comprehensive diary up to 90 days, we selected all patients who recorded at least 1 episode of migraine aura. To find risk indicators and triggers of aura, HoA, and MoA, we analyzed 56 variables and calculated univariate and multivariate generalized linear mixed models. Results.- Fifty-four patients recorded a total of 4562 patient days including 354 days with migraine aura. In the multivariate analysis, the risk of aura was statistically significantly increased by smoking, menstruation, and hunger, and it was decreased by holidays and days off. The risk of HoA and/or MoA was increased during menstruation, by psychic tension, tiredness, and odors, and it was decreased by smoking. Conclusion.- Menstruation is the most prominent factor increasing the risk of aura as well as that of HoA and MoA. Smoking shows the most striking difference increasing the risk of aura, but decreasing the risk of HoA and MoA.     

Chronic Migraine Prevalence,Disability, and Sociodemographic Factors: Results From the American Migraine Prevalence and Prevention Study

Objectives.— To estimate the prevalence and distribution of chronic migraine (CM) in the US population and compare the age‐ and sex‐specific profiles of headache‐related disability in persons with CM and episodic migraine. Background.— Global estimates of CM prevalence using various definitions typically range from 1.4% to 2.2%, but the influence of sociodemographic factors has not been completely characterized. Methods.— The American Migraine Prevalence and Prevention Study mailed surveys to a sample of 120,000 US households selected to represent the US population. Data on headache frequency, symptoms, sociodemographics, and headache‐related disability (using the Migraine Disability Assessment Scale) were obtained. Modified Silberstein–Lipton criteria were used to classify CM (meeting International Classification of Headache Disorders, second edition, criteria for migraine with a headache frequency of ≥15 days over the preceding 3 months). Results.— Surveys were returned by 162,756 individuals aged ≥12 years; 19,189 individuals (11.79%) met International Classification of Headache Disorders, second edition, criteria for migraine (17.27% of females; 5.72% of males), and 0.91% met criteria for CM (1.29% of females; 0.48% of males). Relative to 12 to 17 year olds, the age‐ and sex‐specific prevalence for CM peaked in the 40s at 1.89% (prevalence ratio 4.57; 95% confidence interval 3.13‐6.67) for females and 0.79% (prevalence ratio 3.35; 95% confidence interval 1.99‐5.63) for males. In univariate and adjusted models, CM prevalence was inversely related to annual household income. Lower income groups had higher rates of CM. Individuals with CM had greater headache‐related disability than those with episodic migraine and were more likely to be in the highest Migraine Disability Assessment Scale grade (37.96% vs 9.50%, respectively). Headache‐related disability was highest among females with CM compared with males. CM represented 7.68% of migraine cases overall, and the proportion generally increased with age. Conclusions.— In the US population, the prevalence of CM was nearly 1%. In adjusted models, CM prevalence was highest among females, in mid‐life, and in households with the lowest annual income. Severe headache‐related disability was more common among persons with CM and most common among females with CM.     

Precipitating and Aggravating Factors of Migraine Versus Tension-type Headache

OBJECTIVE: We conducted the present study to determine whether there are headache precipitating and aggravating factors that differentiate migraine from tension-type headache and headache precipitating and aggravating factors that differentiate tension-type headache from migraine. METHODS: We interviewed 38 patients with migraine and 17 patients with tension-type headache (diagnosed using International Headache Society criteria) by telephone, using a questionnaire. The questionnaire inquired about the following precipitating and aggravating headache factors: (1) physical activity, (2) straining, (3) bending over, (4) stress/tension, (5) coughing/sneezing, (6) fatigue, (7) reading, (8) driving, (9) lack of sleep, (10) specific foods/drinks, (11) alcohol, (12) not eating on time, (13) smoke, (14) smell, (15) light, (16) noise, (17) menstruation, and (18) weather. RESULTS: The most common precipitating factors acknowledged by both groups of patients were stress/tension, not eating on time, fatigue, and lack of sleep. Weather, smell, smoke, and light were the precipitating factors that differentiated migraine from tension-type headache. Excluding those factors that are part of the International Headache Society migraine diagnosis, the aggravating factors were straining, bending over, and smell. We found no precipitating or aggravating factors differentiating tension-type headache from migraine. CONCLUSION: Apparently there are precipitating and aggravating factors differentiating migraine from tension-type headache but not vice versa. It is interesting that three of the migraine-specific precipitating factors (ie, weather, smell, and smoke) involve the nose/sinus system, suggesting a greater significance of this system in headache than is generally considered.     

Modifiable Risk Factors for Migraine Progression (or for Chronic Daily Headaches)—Clinical Lessons

Herein we summarize clinical issues gleaned from a full peer-reviewed article on modifiable risk factors for migraine. Since migraine is progressive in some but not in most individuals, identifying patients at risk for progression is crucial. Key interventions include: (1) Decrease headache frequency with behavioral and pharmacologic interventions; (2) Monitor the body mass index and encourage maintenance of normal weight; (3) Avoid medication overuse; (4) Avoid caffeine overuse; (5) Investigate and treat sleep problems and snoring; (6) Screen and treat depression and other psychiatric comorbidities. These recommendations have not been demonstrated to improve outcomes in longitudinal studies.     

Acupuncture in Migraine: Long-term Outcome and Predicting Factors

Twenty-six patients (19 women, 7 men), who suffered from chronic migraine according to IHS criteria, underwent acupuncture. In order to evaluate the long-term stability of treatment effects, patients documented frequency, duration, and intensity of attacks as well as analgesic intake in a migraine diary, which was kept for 5-week periods before treatment, immediately after treatment, and 3 years later. Data showed improvement greater than 33% for 18 patients (69%) at posttreatment and 15 patients (58%) at 3-year follow-up. Drug intake was reduced to 50% and did not re-increase until follow-up. Treatment outcome was associated with personality traits, but not depending on demographic data or severity of migraine.     

Migraine: Epidemiology, Impact, and Risk Factors for Progression

Migraine is a chronic and sometimes progressive disorder characterized by recurrent episodes of headache and associated symptoms. This article reviews the epidemiology of and the risk factors for migraine described in population studies, and discusses the burden of disease and the socioeconomic costs of migraine. In the years prior to puberty, migraine is more common among boys than girls. By the onset of puberty, migraine is more prevalent in girls, and by the late teens, females are about twice as likely to suffer from migraine as males. The prevalence of migraine peaks in both sexes during the most productive years of adulthood (age 25 to 55 years) and, in the United States, the prevalence is higher in individuals of lower socioeconomic status. Direct costs of migraine include the cost of migraine medications and health care expenses. Indirect costs associated with migraine include reduced productivity due to absenteeism and reduced performance while at work. Recent evidence suggests that a subgroup of migraine patients may have a clinically progressive disorder. Future epidemiologic studies should focus on identifying patients who are at higher risk for progression and on assessing the impact of intervention strategies on disease progression.     

Migraine and prothrombotic genetic risk factors

It has been suggested that during attacks of migraine both platelet activation and plasma coagulability are increased. We investigated the prevalence of several prothrombotic genetic risk factors in patients with migraine: factor V R/Q 506, factor II 20210 G/A, decanucleotide insertion/deletion in the factor VII promoter, and the platelet HPA-1 and HPA-2 alloantigenic systems, by genotypic identification in an age- and sex-matched case-control study including 106 patients with migraine (49 with aura, and 57 without aura). The prevalence of all genotypes was similar among case patients and controls. No association in relation to the type of migraine was detected in the factor II, factor VII, HPA-1, or HPA-2 polymorphisms. Our results showed a high prevalence of factor V Leiden in those patients with migraine with aura (6.1%), though that association was not statistically significant. The studied prothrombotic genetic factors do not seem to be associated with the development of migraine and, therefore, are not likely relevant in the previously reported hypercoagulability and platelet hyperaggregability in this disease.     

Precipitating Factors in Migraine: A Retrospective Review of 494 Patients

SYNOPSIS
The predominance of certain triggers for migraine was assessed in 494 migraine patients. Stress (62%) was the most frequently cited precipitant. Weather changes (43%), missing a meal (40%), and bright sunlight (38%) were also prominent factors. Sexual activity (5%) was the precipitant cited by the least number of patients. Significant differences were found between men and women in their responses to weather changes, perfumes, cigarette smoke, missing a meal, and sexual activity.
Spring was cited by 14% of patients as a time for increased migraine attacks, followed by fall (13%), summer (11%), and winter (7%).     

偏头痛发作的血管发育异常及血浆生化因素分析

目的：评价鄂西北居民偏头痛的主要危险因素与偏头痛发生的关系。方法：64例偏头痛患者（头痛组）和50例正常人（正常组）;采用脑血管造影（头痛组64例及正常组5例）和高效液相色谱-紫外光检测法（头痛组64例及正常组50例）了解脑血管发育情况及血浆内5-羟色胺（5-HT）的含量变化。结果：血管组患者脑血管发育变异率高于正常组,血浆5-HT含量低于正常组（P〈0.05）。结论：偏头痛的发生为多因素共同作用的结果,其中脑血管发育异常是重要危险因素。