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偏头痛是一种常见的慢性神经血管性疾患,可引起病人生活质量下降和显著的功能损伤[1]。除疾病本身造成的损害外, 还可与癫痫、抑郁症及情感性精神障碍等多种疾病共患。认知功能减退是病人自我感觉或客观判断的认知功能恶化,在偏头痛的早期即可出现[2]。研究[3]发现,许多偏头痛病人存在不同程度的认知功能障碍,并不为病人所重视。本研究旨在观察偏头痛病人认知功能改变,并对其与抑郁、焦虑的相关性进行分析和评估。
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151例偏头痛病人,经MoCA评分,有38例(25.2%)出现认知功能下降,分为认知下降组;其余113例为正常认知组。2组年龄、性别、偏头痛类型、偏头痛病程、发作持续时间、发作次数等差异均无统计学意义(P>0.05)(见表 1)。
分组 n 年龄
(x±s)/岁男 女 偏头痛类型 有无先兆 偏头痛病程(x±s)/年 发作持续时间(x±s)/h 每月头痛发作次数(x±s) 慢性 发作性 有 无 认知下降组 38 41.5±9.1 11 27 13 25 8 30 5.8±3.1 29.6±16.7 3.5±2.50 正常认知组 113 40.6±9.8 31 82 51 62 19 94 6.1±3.5 31.2±17.1 3.9±3.10 χ2 — 0.49△ 0.03 1.38 0.01 0.47△ 0.52△ 0.72△ P — >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 △示t值 表 1 2组一般临床资料比较(n)
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认知下降组VAS判断的头痛强度更大,HIT-6测评的头痛对日常生活的影响更明显,与正常认知组比较,差异均有统计学意义(P < 0.05)。认知下降组和正常认知组SDS、SAS评分差异亦有统计学意义(P < 0.05)(见表 2)。
分组 n MoCA评分 VAS评分 HIT-6评分 SDS评分 SAS评分 认知下降组 38 23.3±2.5 7.9±2.1 61.1±6.8 58.5±11.5 55.3±12.1 正常认知组 113 27.3±2.1 6.8±2.6 58.3±7.2 53.1±12.7 50.4±12.2 t — 9.66 2.36 2.10 2.32 2.14 P — < 0.01 < 0.05 < 0.05 < 0.05 < 0.05 表 2 2组抑郁、焦虑状态比较
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对偏头痛病人的认知功能与焦虑、抑郁进行Spearman相关性分析,结果显示认知功能障碍与焦虑、抑郁呈正相关(r=0.236、0.281,P < 0.05)。
偏头痛病人认知能力改变及与抑郁、焦虑的相关性研究
Cognitive ability change in migraine patients and its correlation with depression and anxiety
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摘要:
目的探讨偏头痛病人认知能力改变及与抑郁、焦虑的关系。 方法选取偏头痛病人151例,采用蒙特利尔认知评估量表(MoCA)对病人的认知功能进行评价,分为认知下降组和正常认知组。采用一般情况调查表、视觉模拟量表(VAS)、头痛影响试验6(HIT-6)、抑郁自评量表(SDS)、焦虑自评量表(SAS)对2组病人临床病情及精神状态进行评价比较。 结果151例偏头痛病人,有38例(25.2%)出现认知能力下降。认知下降组头痛强度及对日常生活的影响更大(P < 0.05)。认知下降组和正常认知组SDS评分和SAS评分比较差异均有统计学意义(P < 0.05)。Spearman相关性分析显示,认知功能障碍与焦虑、抑郁呈正相关(r=0.236,0.281,P < 0.05)。 结论存在认知功能障碍的偏头痛病人,头痛的严重程度及对日常生活的影响更大,偏头痛的认知功能障碍与抑郁、焦虑有明确的相关性。 Abstract:ObjectiveTo investigate the cognitive changes of migraine patients and its relationship with anxiety and depression. MethodsThe cognitive function in 151 patients with migraine were evaluated using the Montreal cognitive assessment, and the patients were divided into the cognitive decline group and normal cognitive group according to the cognitive function results.The clinical condition and mental state in two groups were evaluated using the general situation questionnaire, visual analog scale(VAS), headache impact test 6, self-evaluation of depression scale(SDS) and self-evaluation of anxiety scale(SAS). ResultsAmong 151 migraine patients, 38 cases(25.2%) with cognitive impairment were found.The effects of intensity of headache on daily life were greater(P < 0.05).The differences of SDS score and SAS score between two groups were statistically significant(P < 0.05).The results of Spearman correlation analysis showed that the cognitive dysfunction was positively correlated with anxiety and depression(r=0.236, 0.281, P < 0.05). ConclusionsAmong the migraine patients with cognitive dysfunction, the severity of headache and its impact on daily life are greater, and the cognitive impairment of migraine is clearly related to the depression and anxiety. -
Key words:
- migraine /
- cognitive function /
- depression /
- anxiety
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表 1 2组一般临床资料比较(n)
分组 n 年龄
(x±s)/岁男 女 偏头痛类型 有无先兆 偏头痛病程(x±s)/年 发作持续时间(x±s)/h 每月头痛发作次数(x±s) 慢性 发作性 有 无 认知下降组 38 41.5±9.1 11 27 13 25 8 30 5.8±3.1 29.6±16.7 3.5±2.50 正常认知组 113 40.6±9.8 31 82 51 62 19 94 6.1±3.5 31.2±17.1 3.9±3.10 χ2 — 0.49△ 0.03 1.38 0.01 0.47△ 0.52△ 0.72△ P — >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 △示t值 表 2 2组抑郁、焦虑状态比较
分组 n MoCA评分 VAS评分 HIT-6评分 SDS评分 SAS评分 认知下降组 38 23.3±2.5 7.9±2.1 61.1±6.8 58.5±11.5 55.3±12.1 正常认知组 113 27.3±2.1 6.8±2.6 58.3±7.2 53.1±12.7 50.4±12.2 t — 9.66 2.36 2.10 2.32 2.14 P — < 0.01 < 0.05 < 0.05 < 0.05 < 0.05 -
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