Service de Médecine Interne et Thérapeutique, Centre de la Douleur, Hôtel Dieu, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, INSERM U 987, Paris, France.
Pain Med. 2013 Nov;14(11):1776-85. doi: 10.1111/pme.12213. Epub 2013 Jul 30.
To analyze pain in systemic sclerosis (SSc), especially its impact and coping strategies, compared with the reference painful inflammatory rheumatological condition, rheumatoid arthritis (RA).
We carried out a cohort study of consecutive inpatients with SSc and RA visiting three university hospitals. We analyzed pain, pain-related interference with daily life, pain catastrophizing, and attitudes, together with quality of life (QoL).
In total, 173 patients were included and 153 were analyzed: 82 SSc and 71 RA patients. Pain frequency did not differ between the two groups (60.8% and 73.1%, respectively), but pain dimension scores in SSc patients were not correlated with disease activity and were significantly lower than those in RA patients. A neuropathic component was associated with higher pain scores in both conditions. Pain was more frequent and more intense in patients with diffuse cutaneous SSc than in patients with limited SSc, but its impact was similar. Pain and its functional consequences interfered less with daily life in SSc than in RA, consistent with the lower expectations concerning the benefits of drug treatment in SSc. However, pain catastrophizing played an important role in both groups.
Pain intensity and dimension scores are lower in SSc patients, particularly those with limited disease, than in RA patients and are not correlated with disease activity. In both conditions, a neuropathic component is associated with higher pain scores and pain catastrophizing is frequent.
分析系统性硬化症（SSc）患者的疼痛情况，特别是与参考痛性炎症性风湿性疾病类风湿关节炎（RA）相比时的疼痛情况及其应对策略。
我们对三家大学医院的连续住院 SSc 和 RA 患者进行了队列研究。我们分析了疼痛、疼痛对日常生活的影响、疼痛灾难化和态度，以及生活质量（QoL）。
共纳入 173 例患者，其中 153 例纳入分析：82 例 SSc 患者和 71 例 RA 患者。两组患者疼痛频率无差异（分别为 60.8%和 73.1%），但 SSc 患者的疼痛维度评分与疾病活动度无关，且明显低于 RA 患者。两种情况下，神经病理性成分与较高的疼痛评分相关。弥漫性皮肤 SSc 患者的疼痛比局限性 SSc 患者更频繁且更剧烈，但疼痛的影响相似。与 RA 相比，SSc 患者的疼痛及其功能后果对日常生活的干扰较小，这与 SSc 患者对药物治疗益处的期望较低有关。然而，疼痛灾难化在两组患者中都起着重要作用。
与 RA 患者相比，SSc 患者的疼痛强度和维度评分较低，尤其是局限性疾病患者，且与疾病活动度无关。在两种情况下，神经病理性成分与较高的疼痛评分和疼痛灾难化相关。
