CAJ | 학술논문

目的探讨伴慢性疼痛的帕金森病(PD)患者疼痛类型及危险因素,并分析疼痛与认知功能的相关性.方法 116例原发性PD患者分为伴疼痛组与不伴疼痛组,统一使用PD评分量表(UPDRS)、Hoehn-Yahr(H-Y)分期,汉密顿抑郁量表(HRSD,24项)、视觉模拟评分法(VAS)、蒙特利尔认知评估量表(MoCA)等进行评估.结果伴慢性疼痛组UPDRS各项得分、H-Y分期及HRSD得分均高于不伴疼痛组,差异均有统计学意义(P值均＜0.05).logistic回归分析显示只有HRSD得分有统计学意义(OR=1.093,P=0.007).伴慢性疼痛PD患者的“延迟记忆”得分低于不伴疼痛患者(1.9±1.3比2.5±1.3),差异有统计学意义(P=0.020);疼痛出现在运动症状之前患者的延迟记忆得分明显低于疼痛出现于运动症状以后的患者(1.2±1.2比2.2±1.3),差异有统计学意义(P=0.015).结论骨骼肌疼痛是PD患者最为常见的疼痛类型,抑郁可能是导致PD合并疼痛的独立危险因素,伴慢性疼痛PD患者的认知功能损害主要表现为延迟记忆障碍.
목적 탐토반만성동통적파금삼병(PD)환자동통류형급위험인소,병분석동통여인지공능적상관성.방법 116례원발성PD환자분위반동통조여불반동통조,통일사용PD평분량표(UPDRS)、Hoehn-Yahr(H-Y)분기,한밀돈억욱량표(HRSD,24항)、시각모의평분법(VAS)、몽특리이인지평고량표(MoCA)등진행평고.결과 반만성동통조UPDRS각항득분、H-Y분기급HRSD득분균고우불반동통조,차이균유통계학의의(P치균＜0.05).logistic회귀분석현시지유HRSD득분유통계학의의(OR=1.093,P=0.007).반만성동통PD환자적“연지기억”득분저우불반동통환자(1.9±1.3비2.5±1.3),차이유통계학의의(P=0.020);동통출현재운동증상지전환자적연지기억득분명현저우동통출현우운동증상이후적환자(1.2±1.2비2.2±1.3),차이유통계학의의(P=0.015).결론 골격기동통시PD환자최위상견적동통류형,억욱가능시도치PD합병동통적독립위험인소,반만성동통PD환자적인지공능손해주요표현위연지기억장애.
Objective To explore the type and etiology of chronic pain in patients with Parkinson's disease (PD),and to assess the association between pain and cognitive function.Methods A total of 116 PD patients were enrolled in the study and assessed with the following rating scales:Unified Parkinson's Disease Rating Scale (UPDRS),Hoehn-Yahr Scale (H-Y),Hamilton Depression Rating Scale for Depression(HRSD),Visual Analogue Scale (VAS) and Montreal Cognitive Assessment (MoCA).Results Compared with PD patients without pain,PD patients with pain had higher scores of UPDRS,H-Y and HRSD rating scales.Depression(scores of HRSD) was the only factor associated with pain showed by the Logistic regression model (P =0.007).PD patients with pain had lower scores of delayed recall (P =0.020).PD patients with pain happened before their motor symptoms had a lower score of delayed recall (P =0.015).Conclusions Musculoskeletal pain is the most common type in PD patients with pain.Depression is probably an independent risk factor for pain in PD patients.Delayed recall is the dominant impaired cognitive function.