常见儿科疼痛疾病及其临床关联

Common Pediatric Pain Disorders and Their Clinical Associations.

作者信息

Donnelly Theresa J, Bott Aneeka, Bui Minh, Goh Shuxiang, Jaaniste Tiina, Chapman Cindy, Crawford Matthew, Hopper John L, Champion David

机构信息

*Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick †Melbourne School of Population and Global Health, The University of Melbourne, Carlton ‡School of Women's and Children's Health, University of New South Wales, Kensington, NSW, Australia.

出版信息

Clin J Pain. 2017 Dec;33(12):1131-1140. doi: 10.1097/AJP.0000000000000496.

DOI:10.1097/AJP.0000000000000496

PMID:28272118

Abstract

BACKGROUND

Common childhood pain conditions (nonmigraine headache, migraine, recurrent abdominal pain, growing pains, low back pain) and persistent pains are often associated with each other and have significant implications in later life. Emerging evidence suggests additional associations between these pain conditions and restless legs syndrome, iron deficiency, anxiety, and depression. The aim of this cross-sectional study in pediatric twin individuals and their siblings was to investigate these associations.

MATERIALS AND METHODS

Surveys were sent to Australian twin families via the Australian Twin Registry, yielding responses from 2530 pediatric individuals. The lifetime prevalence of the common pain disorders of childhood and of other persistent pains, restless legs syndrome and iron deficiency, and anxious/depressed score were determined by questionnaires. Random-effects logistic regression modeling was used to investigate univariate and multivariate associations between conditions.

RESULTS

Univariate associations were found between each of the pain conditions and persistent pain, and between the pain conditions with restless legs syndrome, iron deficiency, and anxious/depressed score. Derivative multivariate analyses retained statistically significant associations between each of the pain disorders included in the respective models (odds ratios [OR], 1.69-7.04) with the exception of growing pains with persistent pain. Of the nonpain conditions included in the multivariate analyses, restless legs syndrome remained associated with growing pains (OR, 8.50) and persistent pain (OR, 2.01). Iron deficiency remained significantly associated with migraine (OR, 2.38), persistent pain (OR, 3.70), and restless legs syndrome (OR, 5.10).

CONCLUSIONS

In light of their extensive associations, the common pain conditions, persistent pain, restless legs syndrome, iron deficiency, anxiety and depression, are likely to involve common etiological mechanisms that warrant further investigation.

摘要

背景

常见的儿童疼痛病症（非偏头痛性头痛、偏头痛、复发性腹痛、生长痛、腰痛）和持续性疼痛通常相互关联，且对日后生活有重大影响。新出现的证据表明，这些疼痛病症与不安腿综合征、缺铁、焦虑和抑郁之间还存在其他关联。这项针对儿科双胞胎个体及其兄弟姐妹的横断面研究旨在调查这些关联。

材料与方法

通过澳大利亚双胞胎登记处向澳大利亚双胞胎家庭发送调查问卷，共收到2530名儿科个体的回复。通过问卷调查确定儿童常见疼痛障碍、其他持续性疼痛、不安腿综合征和缺铁的终生患病率，以及焦虑/抑郁评分。采用随机效应逻辑回归模型研究各病症之间的单变量和多变量关联。

结果

发现每种疼痛病症与持续性疼痛之间，以及疼痛病症与不安腿综合征、缺铁和焦虑/抑郁评分之间存在单变量关联。除生长痛与持续性疼痛外，各模型中纳入的每种疼痛障碍之间的衍生多变量分析均保留了统计学上显著的关联（优势比[OR]，1.69 - 7.04）。在多变量分析中纳入的非疼痛病症中，不安腿综合征仍与生长痛（OR，8.50）和持续性疼痛（OR，2.01）相关。缺铁仍与偏头痛（OR，2.38）、持续性疼痛（OR，3.70）和不安腿综合征（OR，5.10）显著相关。