中枢敏化对类风湿性关节炎患者临床指标的影响。

IF 4.9 2区 医学 Q1 ECONOMICS
Value in Health Pub Date : 2024-04-22 eCollection Date: 2024-01-01 DOI:10.14744/nci.2023.81231
Nilgun Mesci, Erkan Mesci, Emine Unkun Kandemir, Duygu Geler Kulcu, Talha Celik
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引用次数: 0

摘要

研究目的本研究旨在探讨中枢敏化(CS)对类风湿关节炎(RA)患者疼痛敏感性、疾病活动性、神经病理性症状和生活质量(QoL)的影响:根据美国风湿病学会和欧洲抗风湿病联盟(ACR/EULAR)2010 年的分类标准确诊为类风湿关节炎的 60 名患者被纳入研究。患者评估工具包括疼痛视觉模拟量表(VAS)、疼痛压力阈值(PPT)、28个关节疾病活动度评分(DAS-28)、中枢敏感性清单(CSI)和类风湿关节炎QoL问卷:结果:29 名患者(48.3%)被确诊为中枢过敏。尽管红细胞沉降率(ESR)、C 反应蛋白和关节肿胀计数在 CS 患者和非 CS 患者之间具有可比性,但在 CS 患者中观察到较高的 VAS、关节触痛计数和 DAS-28 评分(均为 pW),并且 CS 患者的斜方肌(PPTT)较低(分别为 p=0.004 和 p=0.001)。研究发现,随着 CSI 评分的增加,神经性疼痛成分增加,生活质量下降(均为 p=0.000):结论:CSI的存在会导致RA患者对疼痛的敏感性以及对疾病活动性的高估。RA患者不应忽视CS的存在,以避免过度治疗炎症,并确定非痉挛性疼痛的治疗需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of central sensitization on clinical parameters in patients with rheumatoid arthritis.

Objective: This study aimed to investigate the effects of central sensitization (CS) on pain sensitivity, disease activity, neuropathic symptoms and quality of life (QoL) in patients with rheumatoid arthritis (RA).

Methods: Sixty patients diagnosed with RA according to the American College of Rheumatology and the European League Against Rheumatism (ACR/EULAR) 2010 classification criteria were included in the study. Patient assessment tools included visual analog scale (VAS) for pain, algometer for pain pressure threshold (PPT), disease activity score in 28 joints (DAS-28) for disease activity (DA), central sensitization inventory (CSI) for CS and rheumatoid arthritis QoL questionnaire for QoL.

Results: Central sensitization was identified in 29 (48.3%) patients. Although erythrocyte sedimentation rate (ESR), C-reactive protein and swollen joint count were comparable between patients with or without CS, higher VAS, tender joint count and DAS-28 scores were observed in patients with CS (all p<0.05). Pain pressure thresholds (PPT) at the wrist (PPTW) and the trapezius muscle (PPTT) were lower in patients with CS (p=0.004, p=0.001, respectively). It was found that neuropathic pain components increased and quality of life decreased as CSI scores increased (all p=0.000).

Conclusion: The presence of CS leads to pain sensitivity as well as overestimation of disease activity in RA patients. The presence of CS should not be overlooked in RA patients to avoid overtreatment for inflammation and to determine the treatment need for nociplastic pain.

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来源期刊
Value in Health
Value in Health 医学-卫生保健
CiteScore
6.90
自引率
6.70%
发文量
3064
审稿时长
3-8 weeks
期刊介绍: Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.
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