韩国帕金森病和药物诱导性帕金森病的患病率和发病率。
Prevalence and incidence of Parkinson's disease and drug-induced parkinsonism in Korea.
机构信息
College of Pharmacy, Pusan National University, Busan, South Korea.
Department of Neurology, Chung-Ang University College of Medicine, Seoul, South Korea.
出版信息
BMC Public Health. 2019 Oct 22;19(1):1328. doi: 10.1186/s12889-019-7664-6.
BACKGROUND
Parkinson's disease (PD) and drug-induced parkinsonism (DIP) are the major diseases of parkinsonism. To better understand parkinsonism, we aimed to assess the prevalence and incidence of PD and DIP in Korea from 2012 to 2015.
METHODS
We used the Health Insurance Review and Assessment Service database, which covers the entire population in Korea. We used claims during 2011-2015 to assess epidemiology of PD and DIP during 2012-2015. Retrospective cross-sectional study design was employed to assess prevalence, whereas retrospective cohort study design was used to determine incidence. Patients with at least one claim with ICD-10 G20 and who received antiparkinsonian drugs for at least 60 days were classified as having PD. We excluded patients with antiparkinsonian drugs that can be used for indications other than PD. Patients with at least one claim with ICD-10 G211 or G251 during the prescription period of drugs that are frequently related with DIP were classified as having DIP. Incident cases had a disease-free period of 1 year before diagnosis. To evaluate the significance of changes in the prevalence or incidence over time, Poisson regression was used to determine p for trend.
RESULTS
The prevalence of PD increased from 156.9 per 100,000 persons in 2012 to 181.3 per 100,000 persons in 2015 (p for trend< 0.0001). The incidence of PD decreased steadily from 35.4 per 100,000 person-years in 2012 to 33.3 per 100,000 person-years in 2015 (p for trend< 0.0001). The prevalence of DIP increased from 7.3 per 100,000 persons in 2012 to 15.4 per 100,000 persons in 2015 (p for trend< 0.0001) and the incidence of DIP increased from 7.1 per 100,000 person-years in 2012 to 13.9 per 100,000 person-years in 2015 (p for trend< 0.0001).
CONCLUSIONS
Our study suggests that the incidence of PD has gradually decreased whereas, the incidence of DIP increased from 2012 to 2015. Further studies are warranted to examine possible causes of increased DIP incidence in order to develop management strategy for parkinsonism.
背景
帕金森病（PD）和药物诱导的帕金森综合征（DIP）是帕金森综合征的主要疾病。为了更好地了解帕金森综合征，我们旨在评估 2012 年至 2015 年韩国 PD 和 DIP 的患病率和发病率。
方法
我们使用了涵盖韩国全部人口的健康保险审查和评估服务数据库。我们使用了 2011 年至 2015 年的理赔记录，以评估 2012 年至 2015 年期间 PD 和 DIP 的流行病学情况。采用回顾性横断面研究设计来评估患病率，而采用回顾性队列研究设计来确定发病率。至少有一次 ICD-10 G20 索赔记录且至少接受 60 天抗帕金森病药物治疗的患者被归类为患有 PD。我们排除了使用可用于 PD 以外适应证的抗帕金森病药物的患者。在药物处方期间至少有一次 ICD-10 G211 或 G251 索赔记录的患者被归类为患有 DIP。在诊断前有 1 年无疾病期的患者为新发病例。为了评估患病率或发病率随时间变化的意义，我们使用泊松回归确定趋势 p 值。
结果
PD 的患病率从 2012 年的每 100,000 人 156.9 例增加到 2015 年的每 100,000 人 181.3 例（趋势 p<0.0001）。PD 的发病率从 2012 年的每 100,000 人年 35.4 例稳步下降至 2015 年的每 100,000 人年 33.3 例（趋势 p<0.0001）。DIP 的患病率从 2012 年的每 100,000 人 7.3 例增加到 2015 年的每 100,000 人 15.4 例（趋势 p<0.0001），发病率从 2012 年的每 100,000 人年 7.1 例增加到 2015 年的每 100,000 人年 13.9 例（趋势 p<0.0001）。
结论
我们的研究表明，PD 的发病率已逐渐下降，而 DIP 的发病率从 2012 年到 2015 年有所增加。需要进一步研究以探讨 DIP 发病率增加的可能原因，以便制定帕金森综合征的管理策略。
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