老年帕金森病伴疼痛患者的临床特征

Clinical features of Parkinson＇s disease combined with pain in the elderly

目的观察老年帕金森病（Parkinson’S disease，PD）伴慢性疼痛患者的临床特征。方法收集366例原发性PD伴疼痛患者，依据年龄分为老年组289例和非老年组77例，进行视觉模拟评分（VAS）、统一PD评定量表（UPDRS）、Hoehn-Yahr（H—Y）分期、焦虑自评量表（SAS）、抑郁自评量表（SDS）、简易疼痛量表（BPI）等评估。结果老年PD伴疼痛患者UPDRSⅡ、Ⅲ、Ⅳ、H—Y分期、VAS和BPI的子项13常生活、工作、睡眠、行走能力及社交评分分别为（13．7．4±5．3）分、（27．3±12．9）分、（2．3±2．2）分、（2．4±1．0）期、（63．3±25．6）分、（5．3±2．7）分、（5．9±3．2）分、（6．3±2．5）分、（4．7±3．1）分、（3．2±2．1）分，高于非老年PD伴疼痛患者（12．3±6．3）分、（23．3±9．6）分、（1．7±1．3）分、（2．1±0．9）期、（56．6±25．0）分、（4．6±2．7）分、（5．1±2．8）分、（5．6±2．6）分、（3．8±2．0）分、（2．6±2．5）分，差异均有统计学意义（t=1．976、2．539、2．287、2．381、2．050、2．021、1．997、2．165、2．420、2．134，均P〈0．05）；两组患者SAS、SDS和BPI另2个子项生活乐趣和情绪评分差异无统计学意义（均P〉0．05）；老年PD患者伴疼痛组存在2种及以上PD相关疼痛类型的比率41．2％（119例），较非老年组23．4Yoo（18例）更高，但接受相关疼痛治疗的比率更少[29．8％（86例）比51．9％（40例）]（χ2=8．190、13．260，均P〈0．05）。结论老年PD伴疼痛患者疼痛程度重，与PD相关的疼痛类型多，生活质量受影响，应加强对该人群的干预治疗。

Objective To analyze the clinical features of Parkinson＇s disease （PD） combined with chronic pain in the elderly. Methods A total of 366 idiopathic PD patients experiencing pain were enrolled and divided into two groups： the elderly group （n： 289） and the young group （n= 77）. Rating scales including Visual Analogue Scale （VAS）, Unified Parkinson＇s Disease Rating Scale （UPDRS）, Hoehn Yahr （H-Y） Scale, SelFrating Anxiety Scale （SAS）, Self-rating Depression Scale （SDS） and Brief Pain Inventory （BPI） were evaluated. Results Compared with the young group, the elderly group had evidently higher scores of UPDRS11 , 1H , IV, H-Y Scale, VAS as well as five sub-items of BPI including daily living, working, sleeping, walking ability and social communication （（13.7±5.3） v.v （12.3±）, （27.3±12.9）vs.（23.3±.6）, （2.3±2.2）vs（1.7±1.3）, （2.4±1.0）vs （2.1±0. 9） , （63. 3±25. 6） w （56.6±25.0）, （5.3±2.7）v,v （4.6±）, （5.9±3.2）vs. （5. 1±2.8）, （6.3±2.5）vx （5.6±2.6）, （4. 7±3.1） vs （3.8±2.0）, （3.2±2.1）vs. （2.6±.5）, t=1.976, 2.539, 2.287, 2.381, 2.050, 2.021, 1.997, 2.165, 2.420, 2.134, respectively, all P〈0. 051. No significant differences were found in SAS, SDS or other sub-items of BPI such as life pleasure and mood scores between the two groups （all P〈0.05）. Compared with the young group, patients in the elderly group had a higher ratio of two or more pain types associated with PD（41.2% （119/299）w 23.4% （18/77）, χ2=8. 190, P〈0.05）, but a lower ratio of pain-related treatment（29.76% （86/299）w 51.95% （40/77）, χ2 =13. 260, P〈0. 051. Conclusions Pain in elderly PD patients is more severe , shows more diverse types, and significantly affects the quality of life. Enhanced intervention is needed.