使用袖带压力或算法测试血友病患者的反常疼痛敏感性。

IF 1.5 Q4 CLINICAL NEUROLOGY
Scandinavian Journal of Pain Pub Date : 2024-04-09 eCollection Date: 2024-01-01 DOI:10.1515/sjpain-2023-0128
Pia Ransmann, Fabian Tomschi, Alexander Schmidt, Marius Brühl, Thomas Hilberg
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引用次数: 0

摘要

简介:由于血友病关节病变,疼痛是血友病患者(PwH)的常见并发症。本研究旨在通过袖带压力测试与艾氏测试的比较,探讨血友病患者对疼痛的敏感性。对关节健康状况进行了评估。使用数字评分量表对主观疼痛进行评估。疼痛敏感度通过压力测痛法和袖带压力测痛法进行测量。测量了膝关节、踝关节和前额的压痛阈值(PPTa)。随后,在左右小腿处测量袖带压力阈值(PPTcuff)。在这两种情况下,较低的数值代表较高的疼痛敏感度:结果:PwH 的关节健康状况比 Con 差。由于 PwH 的膝关节和踝关节的 PPTa 值较低,因此 PwH 的疼痛敏感性高于 Con。前额的 PPTa 则没有差异。与此形成鲜明对比的是,PwH 两腿的 PPTcuff 值较 Con 为高,表明其疼痛敏感性较低:结论:虽然 PwH 的膝关节和踝关节的 PPTa 值较低,但与 Con 相比,PwH 的 PPTcuff 值较高。这揭示了一个矛盾的情况,即 PwH 会经历局部、关节和血友病关节相关的疼痛,而未受影响的软组织结构的疼痛敏感性较低。解释 PPTcuff 结果的原因仍然难以捉摸,但可能是应对策略抵消了慢性关节疼痛,导致非受影响结构的敏感性降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Paradox pain sensitivity using cuff pressure or algometer testing in patients with hemophilia.

Introduction: Pain is a common comorbidity in patients with hemophilia (PwH) due to hemophilic arthropathy. This study aims to explore pain sensitivity in PwH methodologically investigating in cuff pressure testing compared to algometer testing.

Methods: 37 PwH and 35 healthy control subjects (Con) enrolled in this study. Joint health status was assessed. Subjective pain was evaluated using numeric rating scales. Pain sensitivity was measured with pressure algometry and cuff pressure algometry. Pressure pain thresholds of the algometer (PPTa) were measured at knee, ankle joints, and forehead. Subsequently, thresholds of cuff pressure were measured at the left and right lower legs (PPTcuff). In both, lower values represent higher pain sensitivity.

Results: PwH exerted a worse joint health status than Con. Pain sensitivity was higher in PwH compared to Con as PPTa of the knee and ankle joints were lower in PwH. No difference was observed in PPTa at the forehead. Contrastingly, lower pain sensitivity was detected in PwH by higher PPTcuff values compared to Con in both legs.

Conclusion: While PPTa of the knee and ankle joints are lower in PwH, PPTcuff are higher in PwH compared to Con. This reveals a paradox situation, highlighting that PwH experience local, joint- and hemophilic arthropathy-related pain, whereas pain sensitivity of non-affected soft tissue structures is lower. The reasons explaining the PPTcuff results remain elusive but might be explained by coping strategies counteracting chronic joint pain, resulting in lower sensitivity at non-affected structures.

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来源期刊
Scandinavian Journal of Pain
Scandinavian Journal of Pain CLINICAL NEUROLOGY-
CiteScore
3.30
自引率
6.20%
发文量
73
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