Vanderbilt University School of Medicine and The Monroe Carell Jr., Children's Hospital at Vanderbilt, Nashville, Tennessee, USA Vanderbilt Kennedy Center for Research on Human Development, Nashville, Tennessee, USA Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Pain. 2011 Apr;152(4):802-808. doi: 10.1016/j.pain.2010.12.032. Epub 2011 Feb 1.
Idiopathic or functional abdominal pain (FAP) is common in school-age children and typically reflects a functional gastrointestinal disorder (FGID). FGIDs in adults have been distinguished by enhanced responses of the central nervous system to pain stimuli, known as central sensitization. This study investigated whether adolescents and young adults with a history of pediatric FAP (n=144), compared with well control subjects (n=78), showed enhanced central sensitization demonstrated by greater temporal summation (wind-up) to brief, repetitive heat pulses. We also assessed the role of gender and trait anxiety in wind-up to heat pain. Women with a history of FAP showed greater wind-up to heat pain than men with a history of FAP (P<.05) and well control subjects of both genders (P<.05). Results were similar for FAP participants whose abdominal pain was ongoing at follow-up and those whose pain had resolved. Although anxiety was significantly higher in the FAP group compared with control subjects (P<.01) and in women compared with men (P<.05), anxiety did not explain the increased wind-up observed in women with a childhood history of FAP. Results suggest that women with a pediatric history of FAP may have a long-term vulnerability to pain associated with enhanced central nervous system responses to pain stimuli. Young women with a childhood history of functional abdominal pain may have a long-term vulnerability to pain that is associated with enhanced responses of the central nervous system to pain stimuli.
特发性或功能性腹痛（FAP）在学龄儿童中很常见，通常反映出功能性胃肠疾病（FGID）。成人的 FGID 已被证明与中枢神经系统对疼痛刺激的反应增强有关，称为中枢敏化。本研究旨在调查有儿科 FAP 病史的青少年和年轻人（n=144）与健康对照组（n=78）相比，是否表现出增强的中枢敏化，表现为短暂、重复热脉冲的时间总和（wind-up）增加。我们还评估了性别和特质焦虑在热痛 wind-up 中的作用。有 FAP 病史的女性比有 FAP 病史的男性（P<.05）和两性健康对照组（P<.05）对热痛的 wind-up 更大。在随访时腹痛持续存在的 FAP 参与者和疼痛已缓解的 FAP 参与者中，结果相似。尽管 FAP 组的焦虑明显高于对照组（P<.01），女性高于男性（P<.05），但焦虑并不能解释女性中观察到的增加 wind-up。结果表明，有儿科 FAP 病史的女性可能对与疼痛刺激中枢神经系统反应增强相关的疼痛长期脆弱。有儿童期功能性腹痛病史的年轻女性可能对与疼痛刺激中枢神经系统反应增强相关的疼痛长期脆弱。
