Department of Anesthesiology, Kaohsiung Veterans General Hospital, Pingtung Branch, Pingtung, Taiwan.
Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Pain. 2017 Jul;158(7):1234-1240. doi: 10.1097/j.pain.0000000000000904.
The aim of this study was to evaluate the incidence and clinical features of musculoskeletal pain (MSP) in patients with Parkinson disease (PD) compared with a control group without the disease. The retrospective cohort study used a subset of the Taiwan National Health Insurance Research Database (NHIRD) comprising information on 1 million beneficiaries randomly sampled from the entire population of Taiwan. A total of 490 patients aged 50 and above with newly diagnosed Parkinson disease were identified during a period from 2000 to 2005. Among them, 199 developed MSP after PD. The control group consisted of 1960 participants without PD over the study period randomly selected by matching PD cases according to the date of PD incidence, age, and sex. The study groups were then followed to the end of 2007. Musculoskeletal pain was the end point. The incidence rate ratios of MSP were higher in the PD group than in the control group, representing an adjusted hazard ratio of 1.31 (95% confidence interval 1.09 to 1.58). PD was associated with a significantly elevated risk of MSP in all sex and age stratifications, with the highest hazard ratio noted for middle-aged male patients with PD, followed by older male patients with PD. This study showed that the PD may significantly increase the risk of developing MSP. The risk of developing MSP seems to be greatest for middle-aged male patients with PD. Clinicians should be more alert for MSP in patients with PD, and early intervention should be considered.
本研究旨在评估与无该疾病的对照组相比，帕金森病 (PD) 患者的肌肉骨骼疼痛 (MSP) 发生率和临床特征。该回顾性队列研究使用了来自台湾全民健康保险研究数据库 (NHIRD) 的一个子集，该数据库包含了从台湾全部人口中随机抽取的 100 万受益人的信息。在 2000 年至 2005 年期间，共确定了 490 名年龄在 50 岁及以上的新诊断为帕金森病的患者。其中，199 名在 PD 后发生 MSP。对照组由在研究期间通过与 PD 病例按 PD 发病日期、年龄和性别匹配随机选择的 1960 名无 PD 的参与者组成。然后对研究组进行随访至 2007 年底。肌肉骨骼疼痛是终点。PD 组的 MSP 发生率高于对照组，调整后的发病率比为 1.31（95%置信区间 1.09 至 1.58）。在所有性别和年龄分层中，PD 与 MSP 风险显著升高相关，PD 中中年男性患者的风险比最高，其次是 PD 老年男性患者。本研究表明，PD 可能显著增加发生 MSP 的风险。PD 中中年男性患者发生 MSP 的风险似乎最大。临床医生应更加警惕 PD 患者的 MSP，并考虑早期干预。
