儿童人群中过敏性疾病与偏头痛之间的关联：一项全国性队列研究

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中文摘要

背景： 偏头痛是儿童中相对常见的神经系统疾病。儿童人群中偏头痛与过敏性疾病之间可能存在关联已被提出。本研究旨在探讨偏头痛儿童中过敏性疾病的患病率和分布。
方法： 我们利用以色列Clalit健康服务机构的电子病历数据开展了一项全国性回顾性队列研究。纳入2000年1月1日至2023年6月30日期间被诊断为偏头痛的5-18岁儿童。对偏头痛患者的人口学特征和过敏共病（包括哮喘、过敏性鼻炎、过敏性结膜炎、特应性皮炎和食物过敏）进行分析，并按是否合并过敏性疾病进行分层比较。
结果： 共纳入51,411名偏头痛儿童，其中16,658名（32.4%）至少患有一种过敏性疾病，34,753名（67.6%）无过敏共病。患有过敏性疾病的儿童就诊时年龄大于无过敏性疾病者（中位年龄15[四分位距11-16]岁 vs 13[四分位距10-15]岁；P < 0.001）。过敏性结膜炎和过敏性鼻炎是最常见的过敏性疾病。在不同年龄组、部门、社会经济地位以及过敏表型的性别特异性分布方面观察到显著差异。
结论： 过敏共病在偏头痛儿童中常见，其中过敏性结膜炎和过敏性鼻炎是最常见的相关疾病。这些发现强调需要加强对偏头痛儿科患者共存的过敏性疾病的临床关注。它们进一步表明，神经-过敏综合评估可能改善该人群的临床管理。

英文摘要

BACKGROUND: Migraine is a relatively common neurologic disorder among children. A possible association between migraine and allergic diseases in the pediatric population has been suggested. This study aimed to explore the prevalence and distribution of allergic disorders among children with migraine.
METHODS: We conducted a nationwide retrospective cohort study using electronic medical record data from Clalit Health Services, Israel. Children aged 5-18 years who were diagnosed with migraine between January 1, 2000, and June 30, 2023, were included. Demographic characteristics and allergic comorbidities, including asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, and food allergy, were analyzed and compared in patients with migraine, stratified by the presence or absence of concomitant allergic disease.
RESULTS: A total of 51,411 children with migraine were included, of whom 16,658 (32.4%) had at least one allergic disease and 34,753 (67.6%) had no allergic comorbidity. Children with allergic disease were older at presentation than those without allergic disease (median age 15 [interquartile range 11-16] vs 13 [interquartile range 10-15] years; P < 0.001). Allergic conjunctivitis and allergic rhinitis were the most common allergic disorders. Significant differences were observed across age groups, sectors, socioeconomic statuses, and sex-specific distributions of allergic phenotypes.
CONCLUSIONS: Allergic comorbidity is common among children with migraine, with allergic conjunctivitis and allergic rhinitis representing the most frequent associated conditions. These findings underscore the need for heightened clinical attention to co-occurring allergic disease in pediatric patients with migraine. They further indicate that an integrated neurologic-allergic evaluation may improve clinical management in this population.