气象因素对丛集性头痛发病的影响

Influence of meteorological factors on incidence of cluster headache

  • 摘要:
      背景  丛集性头痛 (cluster headache,CH)作为少见的原发性头痛,发病具有典型的季节性,但描述气象因素与CH发病之间关系的研究较少。
      目的  描述CH的季节规律并探究CH发病与气象因素之间的关系。
      方法  横断面调查2019年1月- 2021年9月解放军总医院第一医学中心头痛中心和其他9家医院神经内科门诊的204例CH患者,探讨头痛发作与发病日、发病前气象因素的关系。
      结果  共纳入204例患者,其中男性165例,女性39例,平均发病年龄为(33.8±9.3)岁。患者头痛发生季节呈现春季多发、冬季少发的模式。患者发病当日的平均温度16.3(7.3,23.8)℃、昼夜温差11.9(9.0,15.0)℃、平均气压762.7(755.4,768.0) mmHg;1 mmHg=0.133 kPa、相对湿度61.7%(44.1%,76.0%)不是丛集期发生的危险因素(P>0.05)。本组患者中,35例(17.2%)存在丛集期前症状,提示即将到来的丛集发作,当发病2周前有较高的相对湿度时(OR=1.03,95% CI:1.01 ~ 1.05,P=0.012),丛集期前症状出现的风险增加。
      结论  本研究队列的患者丛集期发生最常见于春季;没有观察到丛集期的出现与当日的气温、气压、昼夜温差、相对湿度等气象元素有关,但发病2周前的湿度是丛集期前症状出现的危险因素。

     

    Abstract:
      Background   Cluster headache (CH) is a relatively rare primary headache that is poorly recognized clinically, and its onset has a typical seasonal rhythm. There are few studies describing the relationship between meteorological factors and CH.
      Objective  To explore the seasonal rhythm of CH and the influence of meteorological factors on the incidence and pre-cluster symptoms of CH.
      Methods  A cross-sectional survey was conducted in 204 CH patients from Chinese PLA General Hospital and nine other neurology clinics from January 2019 to September 2021, the relationship between meteorological factors and the incidence of CH and pre-cluster symptoms was analyzed.
      Results  Of the 204 cases, there were 165 males and 39 females. The average age of onset was (33.8±9.3) years. The incidence of cluster periods exhibited a seasonal pattern, with cluster periods being more common in spring and less common in winter. The mean temperature (MdIQR:16.3 7.3, 23.8 ℃), diurnal temperature range (MdIQR: 11.9 9.0, 15.0 ℃), atmospheric pressure (MdIQR:762.7 755.4, 768.0 mmHg), and relative humidity (MdIQR:61.7 44.1, 76.0 %) on the day of CH onset were not the risk factors for the occurrence of the CH (P >0.05). In total, 35 patients (17.2%) had pre-cluster symptoms, indicating an early warning for CH. The risk of the presence of pre-cluster symptoms increased when there was a higher relative humidity on 14 days before onset (OR=1.028, 95% CI: 1.006-1.050, P=0.012).
      Conclusion  In our cohort of patients, CH commonly occurs in spring. The correlation between the meteorological factors and the occurrence of cluster periods needs to be further explored. The humidity of half a month before the onset may be a risk factor for the occurrence of pre-cluster symptoms.

     

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