中国临床神经科学
中國臨床神經科學
중국림상신경과학
CHINESE JOURNAL OF CLINICAL NEUROSCIENCES
2014年
6期
619-625
,共7页
宋玉%张亮%暴杰%潘卫东%刘军%王厹东%吴云成%李文伟%刘毅%吕桦
宋玉%張亮%暴傑%潘衛東%劉軍%王厹東%吳雲成%李文偉%劉毅%呂樺
송옥%장량%폭걸%반위동%류군%왕구동%오운성%리문위%류의%려화
帕金森病%帕金森病相关疼痛%骨骼肌疼痛%神经根痛%运动障碍疼痛%中枢性疼痛
帕金森病%帕金森病相關疼痛%骨骼肌疼痛%神經根痛%運動障礙疼痛%中樞性疼痛
파금삼병%파금삼병상관동통%골격기동통%신경근통%운동장애동통%중추성동통
Parkinson’s disease%Parkinson’s disease related pain%musculoskeletal pain%radicular-neuropathic pain%dystonic pain%central or primary pain
目的：评估上海地区原发性帕金森病(PD)患者中与PD相关疼痛症状的患病率及流行病学特征。方法对上海市12个综合性医院共1058例诊断明确的原发性PD患者进行结构问卷调查。包括运动障碍的严重程度、抗PD治疗、疼痛相关数据(疼痛发作时间点、持续时间、程度、部位、其他症状、治疗情况)等资料进行收集与分析。结果1058例PD患者中1096例完成调查，约有28.8%(296例)有PD相关性疼痛症状。在PD早期阶段，与男性PD疼痛患者比较女性具有发病率高(P﹤0.05)、年龄层级高(P﹤0.05)、发病年龄高(P﹤0.05)、疼痛频率高(P﹤0.05)、疼痛先于运动障碍症状出现的频率高(P﹤0.05)和疼痛持续时间较长(P﹤0.05)的特点。PD合并疼痛患者就无合并疼痛患者而言，具有较大的左旋多巴等效剂量(P﹤0.05)、睡眠障碍(P﹤0.05)和(或)运动障碍的高发生率(P﹤0.05)。最常见的疼痛类型是骨骼肌疼痛，其次是肌张力障碍疼痛；男性患者疼痛持续时间较女性患者短；疼痛多在服用抗PD药物后出现。结论慢性PD相关性疼痛是常见且复杂的并发症，发病机制复杂；PD慢性疼痛的综合治疗是富有挑战的课题，最终会找到有效的治疗策略。
目的：評估上海地區原髮性帕金森病(PD)患者中與PD相關疼痛癥狀的患病率及流行病學特徵。方法對上海市12箇綜閤性醫院共1058例診斷明確的原髮性PD患者進行結構問捲調查。包括運動障礙的嚴重程度、抗PD治療、疼痛相關數據(疼痛髮作時間點、持續時間、程度、部位、其他癥狀、治療情況)等資料進行收集與分析。結果1058例PD患者中1096例完成調查，約有28.8%(296例)有PD相關性疼痛癥狀。在PD早期階段，與男性PD疼痛患者比較女性具有髮病率高(P﹤0.05)、年齡層級高(P﹤0.05)、髮病年齡高(P﹤0.05)、疼痛頻率高(P﹤0.05)、疼痛先于運動障礙癥狀齣現的頻率高(P﹤0.05)和疼痛持續時間較長(P﹤0.05)的特點。PD閤併疼痛患者就無閤併疼痛患者而言，具有較大的左鏇多巴等效劑量(P﹤0.05)、睡眠障礙(P﹤0.05)和(或)運動障礙的高髮生率(P﹤0.05)。最常見的疼痛類型是骨骼肌疼痛，其次是肌張力障礙疼痛；男性患者疼痛持續時間較女性患者短；疼痛多在服用抗PD藥物後齣現。結論慢性PD相關性疼痛是常見且複雜的併髮癥，髮病機製複雜；PD慢性疼痛的綜閤治療是富有挑戰的課題，最終會找到有效的治療策略。
목적：평고상해지구원발성파금삼병(PD)환자중여PD상관동통증상적환병솔급류행병학특정。방법대상해시12개종합성의원공1058례진단명학적원발성PD환자진행결구문권조사。포괄운동장애적엄중정도、항PD치료、동통상관수거(동통발작시간점、지속시간、정도、부위、기타증상、치료정황)등자료진행수집여분석。결과1058례PD환자중1096례완성조사，약유28.8%(296례)유PD상관성동통증상。재PD조기계단，여남성PD동통환자비교녀성구유발병솔고(P﹤0.05)、년령층급고(P﹤0.05)、발병년령고(P﹤0.05)、동통빈솔고(P﹤0.05)、동통선우운동장애증상출현적빈솔고(P﹤0.05)화동통지속시간교장(P﹤0.05)적특점。PD합병동통환자취무합병동통환자이언，구유교대적좌선다파등효제량(P﹤0.05)、수면장애(P﹤0.05)화(혹)운동장애적고발생솔(P﹤0.05)。최상견적동통류형시골격기동통，기차시기장력장애동통；남성환자동통지속시간교녀성환자단；동통다재복용항PD약물후출현。결론만성PD상관성동통시상견차복잡적병발증，발병궤제복잡；PD만성동통적종합치료시부유도전적과제，최종회조도유효적치료책략。
Aim To assess the prevalence and identify the epidemiological characteristics of Parkinson’s disease (PD) related pain among the patients with idiopathic PD in Shanghai, the pain with Parkinson’s disease (PD) may be more distressing than that with other non-motor disabilities. Methods A total of 1058 patients with deifnite idiopathic PD in 12 hospitals in Shanghai were investigated using a structure questionnaire. The severity of their motor disorders, anti-parkinsonism treatments, and pain related observations, such as time points for onset of pain, duration and degree, body localization, external inlfuences, and treatments for pain, were collected for analysis. Results Approximate 28.4%(296 subjects) of the PD patients suffered from PD related pain. Female patients with pain had a higher age level (P﹤0.05), higher PD onset age (P﹤0.05), higher frequency of pain (P﹤0.05), higher frequency with pain before PD symptoms (P﹤0.05), longer duration of pain (P﹤0.05), and higher incidence of pain in the early stage (P﹤0.05) compared with the male patients. Larger levodopa equivalent doses (P﹤0.05), higher frequencies of sleep disorder (P﹤0.05) and/or motor fluctuation (P﹤0.05), and/or dyskinesia (P﹤0.05) were found in pain patients compared with no pain patients. The most frequent pain type was musculoskeletal followed by dystonia. The male group had much shorter pain duration than the female group. More pain appeared after taking anti-parkinsonism drugs. Conclusion Chronic PD-related pain is a frequent complaint with complex pathogenesis in PD. The challenge of managing pain in PD patients will someday result in speciifc and effective treatment strategies.
