JAMA：青少年偏头痛与婴儿期急腹痛有关

　　芝加哥 – 据4月17日发表在《美国医学会杂志》上的一则研究披露，在一项包括了6-18岁儿童和青少年的研究中，那些经历过偏头痛的人更有可能是在婴儿时期得过急腹痛。

　　根据文章的背景资料：“婴儿急腹痛是婴儿在其生命的头几个月中无法通过安慰而使其停止哭闹的一个常见原因。”“人们对于急腹痛的发病机制及其具有年龄特异性的表现还不甚了解。婴儿急腹痛常常被解读为是一种疼痛综合征而且可能是多因子的。...偏头痛是儿童时期头痛的一种常见原因。但是，这两种类型的疼痛之间是否有某种关系却是未知的。”

　　巴黎APHP-Hospital Robert Debré的Silvia Romanello, M.D.及其同事开展了一项研究，旨在对偏头痛和急腹痛之间的可能关系进行调查。这一病例-对照研究包括了208名6到18岁的孩子，他们在2012年4月至2012年6月间在3家欧洲的三级医院的急症部门就诊时被诊断患有偏头痛。对照组则由471名有着相同年龄范围的孩子组成，他们在同一时期因为轻微的创伤而去过参与该研究的各个医疗中心的急症部门就诊。一个结构式的问卷发现了病例-对照研究参与者在婴儿时患有急腹痛的个人史，并通过健康小册子对其进行了确认。一则对120名诊断患有紧张型头痛的儿童所做的第二个研究是为了测试这种关系的特异性。

　　研究人员发现，那些有偏头痛的儿童比那些没有偏头痛的儿童更有可能在婴儿时期经历了婴儿急腹痛（72.6% vs. 26.5%）。对偏头痛亚型所做的亚型分析证实了婴儿急腹痛与无先兆偏头痛（73.9% vs. 26.5%）或有先兆偏头痛（69.7% vs. 26.5%）之间的关系。这种关系在患有紧张型头痛的孩子中则没有被发现。

　　文章的作者写道：“在婴儿急腹痛与偏头痛之间的联系可能是建立于一种对于无先兆偏头痛及有先兆偏头痛而言所共有的发病机制之上的。我们发现在偏头痛的特征中，只有搏动性疼痛在具有婴儿急腹痛病史的孩子中比在有偏头痛但没有婴儿急腹痛病史的孩子中要更为常见。患有急腹痛的婴儿可能会在其肠道中经历一种与血管周围神经末梢敏感化类似的敏感化过程，尽管这一假说仍需要得到证实。”他们补充说，已知涉及感觉活动调节的分子也可能与其有关。

　　研究人员得出结论，需要做纵向研究来进一步探索急腹痛与儿童时期偏头痛之间的关系。

与偏头痛相关的拓展阅读：

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• AAN2013：褪黑素预防偏头痛或更有效
• Neurology：氯胺酮滴鼻或能减轻偏头痛
• 偏头痛治疗神经刺激仪疗法受青睐
• NEUROLOGY ：偏头痛在先兆期已经出现头痛症状 更多信息请点击：有关偏头痛更多资讯

Association Between Childhood Migraine and History of Infantile Colic
Importance
Infantile colic is a common cause of inconsolable crying during the first months of life and has been thought to be a pain syndrome. Migraine is a common cause of headache pain in childhood. Whether there is an association between these 2 types of pain in unknown.
Objective
To investigate a possible association between infantile colic and migraines in childhood.
Design, Setting, and Participants
A case-control study of 208 consecutive children aged 6 to 18 years presenting to the emergency department and diagnosed as having migraines in 3 European tertiary care hospitals between April 2012 and June 2012. The control group was composed of 471 children in the same age range who visited the emergency department of each participating center for minor trauma during the same period. A structured questionnaire identified personal history of infantile colic for case and control participants, confirmed by health booklets. A second study of 120 children diagnosed with tension-type headaches was done to test the specificity of the association.
Main Outcomes and Measures 
Difference in the prevalence of infantile colic between children with and without a diagnosis of migraine.
Results 
Children with migraine were more likely to have experienced infantile colic than those without migraine (72.6% vs 26.5%; odds ratio [OR], 6.61 [95% CI, 4.38-10.00]; P < .001), either migraine without aura (n = 142; 73.9% vs 26.5%; OR, 7.01 [95% CI, 4.43-11.09]; P < .001), or migraine with aura (n = 66; 69.7% vs 26.5%; OR, 5.73 [95% CI, 3.07-10.73]; P < .001). This association was not found for children with tension-type headache (35% vs 26.5%; OR, 1.46 [95% CI, 0.92-2.32]; P = .10).
Conclusion and Relevance 
The presence of migraine in children and adolescents aged 6 to 18 years was associated with a history of infantile colic. Additional longitudinal studies are required.