Rugbjerg Kathrine, Ritz Beate, Korbo Lise, Martinussen Nick, Olsen Jørgen H
Institute of Cancer Epidemiology, Danish Cancer Society, 49 Strandboulevarden, DK-2100 Copenhagen, Denmark.
BMJ. 2008 Dec 15;337:a2494. doi: 10.1136/bmj.a2494.
To determine whether a hospital contact for a head injury increases the risk of subsequently developing Parkinson's disease.
Population based case-control study.
Denmark.
13 695 patients with a primary diagnosis of Parkinson's disease in the Danish national hospital register during 1986-2006, each matched on age and sex to five population controls selected at random from inhabitants in Denmark alive at the date of the patient's diagnosis (n=68 445).
Hospital contacts for head injuries ascertained from hospital register; frequency of history of head injury.
An overall 50% increase in prevalence of hospital contacts for head injury was seen before the first registration of Parkinson's disease in this population (odds ratio 1.5, 95% confidence interval 1.4 to 1.7). The observed association was, however, due almost entirely to injuries that occurred during the three months before the first record of Parkinson's disease (odds ratio 8.0, 5.6 to 11.6), and no association was found between the two events when they occurred 10 or more years apart (1.1, 0.9 to 1.3).
The steeply increased frequency of hospital contacts for a head injury during the months preceding the date at which Parkinson's disease was first recorded is a consequence of the evolving movement disorder rather than its cause.
确定因头部受伤而与医院接触是否会增加随后患帕金森病的风险。
基于人群的病例对照研究。
丹麦。
1986年至2006年期间丹麦国家医院登记册中初次诊断为帕金森病的13695名患者,每名患者在年龄和性别上与从患者诊断之日仍在世的丹麦居民中随机选取的五名人群对照进行匹配(n = 68445)。
从医院登记册中确定的头部受伤与医院的接触情况;头部受伤史的频率。
在该人群中,帕金森病首次登记之前,头部受伤与医院接触的患病率总体增加了50%(比值比1.5,95%置信区间1.4至1.7)。然而,观察到的关联几乎完全归因于帕金森病首次记录前三个月内发生的损伤(比值比8.0,5.6至11.6),而当这两个事件相隔10年或更长时间发生时,未发现它们之间存在关联(1.1,0.9至1.3)。
在帕金森病首次记录日期前几个月,头部受伤与医院接触的频率急剧增加是运动障碍进展的结果,而非其原因。