脑静脉窦血栓形成后残余头痛相关危险因素研究

Risk factors of residual headache after cerebral venous sinus thrombosis

摘要:

目的：探讨影响脑静脉窦血栓形成（cerebral venous sinus thrombosis，CVST）患者康复后残余头痛的相关危险因素。方法：回顾性分析2016年1月至2019年6月河北省霸州市第二医院收治的符合纳入标准、病历完整的CVST患者临床资料，采用单因素和多因素logistic回归方法分析CVST患者残余头痛的相关危险因素。结果：共有111例CVST患者符合纳入标准，其中38例（34.23%）存在残余头痛。通过单因素分析发现残余头痛组与无残余头痛组相比，其既往头痛病史（Z=-3.723，P=0.000）、抗凝延迟（Z=-3.519，P=0.000）及静脉窦血管未再通（Z=-3.071，P=0.002）存在差异，且差异具有统计学意义。多因素回归分析发现静脉窦未再通是残余头痛的危险因素（OR=6.419，95%CI=1.922~21.438，P=0.003），其次，抗凝延迟（延迟＞7 d）增加了残余头痛的风险（OR=5.248，95%CI=1.710~16.105，P=0.004），既往头痛病史也是残余头痛的独立危险因素（OR=11.98，95%CI=2.451~53.931，P=0.002）。结论：静脉窦再通程度、抗凝延迟及既往头痛病史是CVST患者残余头痛的独立危险因素，及时抗凝及促进CVST患者脑静脉再通或许对减少残余头痛的发生具有重要意义。

Abstract:

Objective：To analyze the related risk factors of residual headache in patients with cerebral venous sinus thrombosis（CVST）. Methods：The study retrospectively analyzed the clinical data of CVST patients who met the inclusion criteria and had complete medical records admitted to The Second Hospital of Bazhou from January 2016 to June 2019，and analyzed the related risk factors of residual headache in CVST patients using univariate and multivariate logistic regression methods. Results：A total of 111 CVST patients met the inclusion criteria，of which 38（34.23%） patients had residual headache. The univariate analysis showed that there were significant differences in the past history of headache（Z=-3.723，P=0.000），delayed anticoagulation（Z=-3.519，P=0.000），and the failure of venous sinus recanalization（Z=-3.071，P=0.002） between the residual headache group and the non-residual headache group. Multivariate regression analysis found that the failure of venous sinus recanalization was a risk factor for residual headache（OR=6.419，95%CI=1.922-21.438，P=0.003）. Secondly，delayed anticoagulation（delayed for more than 7 days） increased the risk of residual headache（OR=5.248，95%CI=1.710-16.105，P=0.004），and past headache history was also an independent risk factor for residual headache（OR=11.98，95%CI=2.451-53.931，P=0.002）. Conclusion：Venous sinus recanalization，delayed anticoagulation and past headache history are independent risk factors of residual headache in CVST patients. Timely anticoagulation and recanalization of cerebral veins in patients with CVST may be of great significance to reduce the occurrence of residual headache.