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腿部不适感觉的鉴别诊断:初级保健人群中不安腿综合征的患病率。

Differential diagnosis of unpleasant sensations in the legs: prevalence of restless legs syndrome in a primary care population.

机构信息

Department of Neurology, J.W. Goethe-University, Frankfurt am Main, Germany; Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany.

出版信息

Sleep Med. 2010 Feb;11(2):161-6. doi: 10.1016/j.sleep.2009.04.009. Epub 2009 Dec 22.

Abstract

BACKGROUND

Restless legs syndrome (RLS) is a common neurological condition. We investigated the prevalence of RLS in patients suffering from unpleasant sensations in the legs.

METHODS

We included 16,543 patients consulting one of 312 primary care practices in Germany on November 8, 2007. All patients filled out a self-assessment questionnaire. Patients who reported suffering from unpleasant sensations in the legs were then assessed by the physician. Main outcome measures were the overall prevalence of unpleasant sensations in the legs and the prevalence of RLS; the most common differential diagnoses in the subpopulation suffered from unpleasant leg sensations.

RESULTS

Out of all participating patients 7704 (46.6%) suffered from unpleasant sensations in the legs and 1758 (10.6%) were diagnosed with RLS according to the four essential clinical criteria. Among patients with unpleasant leg sensations, the prevalence of RLS was considerably higher (22.7%) than in the total population. The most common differential diagnoses were osteoarthritis (21.5%), disc lesion (19.2%), varicose veins (18.8%) and muscle cramps (14.6%). Of the patients with RLS 53.4% had already consulted their physician about their leg problems in the past. Still, only 20.1% of the RLS patients had received the correct diagnosis. Comorbidity rates were significantly increased in RLS patients compared to patients suffering from leg symptoms of other origin.

CONCLUSIONS

This study showed a high prevalence of RLS in primary care patients with unpleasant sensations in the legs. Thus, in patients presenting with these symptoms the diagnosis of RLS should routinely be considered.

摘要

背景

不宁腿综合征(RLS)是一种常见的神经系统疾病。我们研究了在出现腿部不适感觉的患者中 RLS 的患病率。

方法

我们纳入了 2007 年 11 月 8 日在德国 312 家基层医疗诊所就诊的 16543 例患者。所有患者均填写了一份自我评估问卷。报告有腿部不适感觉的患者随后由医生进行评估。主要观察指标为腿部不适感觉的总体患病率和 RLS 的患病率;在有腿部不适感觉的亚人群中最常见的鉴别诊断。

结果

所有参与的患者中,7704 例(46.6%)有腿部不适感觉,1758 例(10.6%)根据四个基本临床标准被诊断为 RLS。在有腿部不适感觉的患者中,RLS 的患病率(22.7%)明显高于总体人群。最常见的鉴别诊断是骨关节炎(21.5%)、椎间盘病变(19.2%)、静脉曲张(18.8%)和肌肉痉挛(14.6%)。在 RLS 患者中,53.4%的患者过去曾就腿部问题咨询过医生。然而,只有 20.1%的 RLS 患者得到了正确的诊断。与有其他腿部症状起源的患者相比,RLS 患者的合并症发生率明显增加。

结论

本研究显示,在出现腿部不适感觉的基层医疗患者中 RLS 的患病率较高。因此,在出现这些症状的患者中,应常规考虑 RLS 的诊断。

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