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赫尔辛基青年卒中登记处中年轻缺血性卒中幸存者的卒中后中枢性疼痛

Central poststroke pain in young ischemic stroke survivors in the Helsinki Young Stroke Registry.

作者信息

Harno Hanna, Haapaniemi Elena, Putaala Jukka, Haanpää Maija, Mäkelä Jyrki P, Kalso Eija, Tatlisumak Turgut

机构信息

From the Departments of Neurology (H.H., E.H., J.P., T.T.), Neurosurgery (M.H.), and Anesthesiology (E.K.), and BioMag Laboratory, HUS Medical Imaging Center (J.P.M.), Helsinki University Central Hospital; and Etera Mutual Pension Insurance Company (M.H.), Helsinki, Finland.

出版信息

Neurology. 2014 Sep 23;83(13):1147-54. doi: 10.1212/WNL.0000000000000818. Epub 2014 Aug 15.

Abstract

OBJECTIVE

We describe the frequency, duration, clinical characteristics, and radiologic correlates of central poststroke pain (CPSP) in young ischemic stroke survivors in a prospective study setting.

METHODS

A questionnaire of pain and sensory abnormalities and EQ-5D quality-of-life questionnaire were sent to all 824 surviving and eligible patients of the Helsinki Young Stroke Registry. Patients (n = 58) with suspected CPSP were invited to a clinical visit and filled in the PainDETECT, Brief Pain Inventory, and Beck Depression Inventory questionnaires.

RESULTS

Of the included 824 patients, 49 had CPSP (5.9%), 246 patients (29.9%) had sensory abnormality without CPSP, and 529 patients (64.2%) had neither sensory abnormality nor CPSP. The median follow-up time from stroke was 8.5 years (interquartile range 5.0-12.1). Patients with CPSP had low quality of life compared to those with sensory abnormality without CPSP (p = 0.007) as well as to those with no sensory abnormality and no CPSP (p < 0.001). Forty (82%) of the patients with CPSP had concomitant other pain. CPSP was associated with moderate (p < 0.001) and severe (p < 0.001) stroke symptoms, but there was no difference in age at stroke onset or subtype of stroke according to the TOAST classification between the groups. Stroke localization was not correlated with CPSP.

CONCLUSIONS

Late persistent CPSP was found in 5.9% of young stroke survivors and was associated with concomitant other pain, impaired quality of life, and moderate or severe stroke symptoms.

摘要

目的

在一项前瞻性研究中,我们描述了年轻缺血性卒中幸存者中枢性卒中后疼痛(CPSP)的发生率、持续时间、临床特征及影像学相关因素。

方法

向赫尔辛基青年卒中登记处的所有824名存活且符合条件的患者发送了疼痛与感觉异常问卷以及EQ-5D生活质量问卷。邀请了58名疑似CPSP的患者前来临床就诊,并填写疼痛检测问卷、简明疼痛问卷和贝克抑郁问卷。

结果

在纳入的824名患者中,49名患有CPSP(5.9%),246名患者(29.9%)有感觉异常但无CPSP,529名患者(64.2%)既无感觉异常也无CPSP。卒中后的中位随访时间为8.5年(四分位间距5.0 - 12.1)。与有感觉异常但无CPSP的患者相比(p = 0.007)以及与既无感觉异常也无CPSP的患者相比(p < 0.001),CPSP患者的生活质量较低。40名(82%)CPSP患者伴有其他疼痛。CPSP与中度(p < 0.001)和重度(p < 0.001)卒中症状相关,但两组之间卒中发病年龄或根据TOAST分类的卒中亚型无差异。卒中部位与CPSP无关。

结论

在5.9%的年轻卒中幸存者中发现了晚期持续性CPSP,其与伴有其他疼痛、生活质量受损以及中度或重度卒中症状相关。

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