Haskell S G, Fiebach N H
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Am J Med Sci. 1997 Apr;313(4):210-4. doi: 10.1097/00000441-199704000-00003.
This article describes patients with nocturnal leg cramps concerning their age, medical problems, and medications, and reviews any medical evaluation performed for the complaint of nocturnal leg cramps. Provided is a retrospective chart review of 50 patients who took quinine sulfate for nocturnal leg cramps. These patients were identified through computerized pharmacy records. A control group was chosen from age-matched patients who took medications other than quinine during the study period. In a university-affiliated Veterans Administration hospital, patients with nocturnal leg cramps had a significantly higher median number of medical problems than controls. Cardiovascular diseases and neurological diseases were significantly more common in patients with nocturnal leg cramps (cases) than in those without (controls) (82% versus 64% and 36% versus 18%, respectively). The most striking differences between patients with cramps and controls were peripheral vascular disease (34% versus 12%, P = 0.09) and peripheral neurological deficit (12% versus 0%, P = 0.012). Patients with nocturnal leg cramps were prescribed significantly more medications than were controls, but no specific medication or type of medication was prescribed more frequently to patients with cramps (other than quinine). Results suggested that men with nocturnal leg cramps have greater medical comorbidity and are prescribed more medications than age-matched control patients. Unlike in previous studies, no evidence was found that specific medications, such as diuretics, betaagonists, or calcium-channel antagonists are associated with nighttime cramps. The significantly increased frequency of peripheral vascular disease and peripheral neurologic deficits in patients with nocturnal leg cramps raised the possibility that these problems contribute to the occurrence of cramps. Although the size of the study and its methodologic limitations preclude definitive conclusions, areas for research to clarify the clinical epidemiology of nocturnal leg cramps are suggested.
本文描述了患有夜间腿部痉挛的患者的年龄、医疗问题和用药情况，并回顾了针对夜间腿部痉挛主诉所进行的任何医学评估。提供了一项对50例服用硫酸奎宁治疗夜间腿部痉挛患者的回顾性图表分析。这些患者是通过计算机化药房记录识别出来的。对照组是从研究期间服用除奎宁以外药物的年龄匹配患者中选取的。在一家大学附属医院的退伍军人管理局医院，夜间腿部痉挛患者的医疗问题中位数显著高于对照组。夜间腿部痉挛患者（病例组）中心血管疾病和神经疾病的发生率显著高于无痉挛患者（对照组）（分别为82%对64%和36%对18%）。痉挛患者与对照组之间最显著的差异是外周血管疾病（34%对12%，P = 0.09）和外周神经功能缺损（12%对0%，P = 0.012）。夜间腿部痉挛患者所开的药物明显比对照组多，但除奎宁外，没有特定药物或药物类型在痉挛患者中更频繁地被开具。结果表明，患有夜间腿部痉挛的男性比年龄匹配的对照患者有更多的合并症，且所开药物更多。与以往研究不同，未发现有证据表明特定药物，如利尿剂、β受体激动剂或钙通道拮抗剂与夜间痉挛有关。夜间腿部痉挛患者外周血管疾病和外周神经功能缺损的频率显著增加，这增加了这些问题导致痉挛发生的可能性。尽管研究规模及其方法学局限性排除了得出确定性结论的可能，但仍提出了一些研究领域以阐明夜间腿部痉挛的临床流行病学。
