Hirose Noriya, Kato Jitsu
Division of Anesthesiology, Department of Anesthesiology, Nihon University School of Medicine, Tokyo 173-8610.
Masui. 2009 Nov;58(11):1360-6.
The salivary enzyme alpha-amylase is an established non-invasive marker of psychological and physiological stress. Since there are positive correlations between salivary alpha-amylase secretion and sympathetic parameter increment during stress, salivary alpha-amylase might be an indicator of sympathetic-adrenal-medullary (SAM) system and central sympathetic activity In contrast, it is well known that sympathetic neural activity is significantly involved in development and deterioration of pain symptoms as a part of pain disorders. Additionally, it has been suggested that various painful stimuli activate SAM system. Taking these data together, salivary alpha-amylase might be an indirect indicator of pain-induced central sympathetic tone. Furthermore, a hand-held device, which is able to measure the activity of salivary alpha-amylase easily and quickly, was developed recently, and we can try to evaluate the condition of pain at the outpatient clinic and the bedside. Though the actual utility of this measuring device for clinical use is unclear, it is hoped that the measuring device of salivary alpha-amylase is one of helpful methods for pain assessment in the future.
唾液酶α-淀粉酶是一种公认的心理和生理应激的非侵入性标志物。由于在应激过程中唾液α-淀粉酶分泌与交感神经参数增加之间存在正相关，唾液α-淀粉酶可能是交感-肾上腺髓质（SAM）系统和中枢交感神经活动的指标。相比之下，众所周知，交感神经活动作为疼痛障碍的一部分，在疼痛症状的发生和恶化中起着重要作用。此外，有研究表明，各种疼痛刺激会激活SAM系统。综合这些数据，唾液α-淀粉酶可能是疼痛诱导的中枢交感神经张力的间接指标。此外，最近开发了一种能够轻松快速测量唾液α-淀粉酶活性的手持设备，我们可以尝试在门诊和床边评估疼痛状况。虽然这种测量设备在临床应用中的实际效用尚不清楚，但希望唾液α-淀粉酶测量设备将来能成为疼痛评估的有用方法之一。
