Gore Mugdha, Brandenburg Nancy A, Dukes Ellen, Hoffman Deborah L, Tai Kei-Sing, Stacey Brett
Avalon Health Solutions, Inc., Philadelphia, Pennsylvania 19102, USA.
J Pain Symptom Manage. 2005 Oct;30(4):374-85. doi: 10.1016/j.jpainsymman.2005.04.009.
Our goal was to evaluate pain severity, pain-related interference with function, sleep impairment, symptom levels of anxiety and depression, and quality of life among patients with painful diabetic peripheral neuropathy (DPN). Participants in a burden of illness survey (n = 255) completed the modified Brief Pain Inventory-DPN (BPI-DPN), MOS Sleep Scale, Hospital Anxiety and Depression Scale (HADS), Short Form Health Survey-12v2 (SF-12v2), and the EuroQoL (EQ-5D). Patients were 61 +/- 12.8 years old (51.4% female), had diabetes for 12 +/- 10.3 years and painful DPN for 6.4 +/- 6.4 years. Average and Worst Pain scores (BPI-DPN, 0-10 scales) were 5.0 +/- 2.5 and 5.6 +/- 2.8. Pain substantially interfered (>or=4 on 0-10 scales) with walking ability, normal work, sleep, enjoyment of life, mood, and general activity. Moderate to severe symptom levels of anxiety and depression (HADS-A and HADS-D scores >or=11 on 0-21 scales) occurred in 35% and 28% of patients, respectively. Patients reported greater sleep problems compared with the general U.S. population and significant impairment in both physical and mental functioning (SF-12v2) compared with subjects with diabetes. The mean EQ-5D utility score was 0.5 +/- 0.3. Greater pain levels in DPN (mild to moderate to severe) corresponded with higher symptom levels of anxiety and depression, more sleep problems, and lower utility ratings and physical and mental functioning, (all Ps < 0.01). Painful DPN is associated with decrements in many aspects of patients' lives: physical and emotional functioning, affective symptoms, and sleep problems. The negative impact is higher in patients with greater pain severity.
我们的目标是评估疼痛性糖尿病周围神经病变（DPN）患者的疼痛严重程度、疼痛对功能的相关干扰、睡眠障碍、焦虑和抑郁症状水平以及生活质量。一项疾病负担调查的参与者（n = 255）完成了改良的糖尿病周围神经病变简明疼痛问卷（BPI-DPN）、MOS睡眠量表、医院焦虑抑郁量表（HADS）、简短健康调查问卷-12v2（SF-12v2）以及欧洲五维健康量表（EQ-5D）。患者年龄为61±12.8岁（51.4%为女性），糖尿病病程为12±10.3年，疼痛性DPN病程为6.4±6.4年。平均疼痛评分和最严重疼痛评分（BPI-DPN，0 - 10分制）分别为5.0±2.5和5.6±2.8。疼痛对行走能力、正常工作、睡眠、生活乐趣、情绪和日常活动有显著干扰（0 - 10分制中≥4分）。分别有35%和28%的患者出现中度至重度焦虑和抑郁症状（HADS-A和HADS-D评分在0 - 21分制中≥11分）。与美国普通人群相比，患者报告有更多睡眠问题，与糖尿病患者相比，在身体和心理功能（SF-12v2）方面有显著损害。EQ-5D效用评分的平均值为0.5±0.3。DPN中更高的疼痛水平（轻度至中度至重度）与更高的焦虑和抑郁症状水平、更多睡眠问题以及更低的效用评分和身体及心理功能相关（所有P值<0.01）。疼痛性DPN与患者生活的许多方面下降有关：身体和情感功能、情感症状以及睡眠问题。疼痛严重程度越高的患者负面影响越大。
