Antunes Fabricio Dias, Propheta Vynicius Goltran Sobral, Vasconcelos Hulemar Andrade, Cipolotti Rosana
Federal University of Sergipe-Brazil, Av. Claudio Batista, s/n, Aracaju, Sergipe, Brazil.
Ann Hematol. 2017 Jul;96(7):1121-1125. doi: 10.1007/s00277-017-2984-z. Epub 2017 Mar 30.
Chronic pain conditions are little studied and may be underestimated in sickle cell disease (SCD). The aim of this study was to identify the occurrence and characteristics of neuropathic pain (NP) in SCD patients. A sample of 56 patients was chosen from a total of 554 patients submitted to the inclusion criteria between 2015 and 2016. The Leeds assessment of neuropathic symptoms and signs scale was used for detecting NP. The groups with and without NP were compared by sex, age, use of hydroxyurea, and sensory changes through Chi-square, Fisher's exact, ANOVA, and Kruskal-Wallis tests. The average age was 20.6 years (SD ± 4.6), 51.8% of the patients were male, and 14 patients (25%) suffered from NP. Most commonly, the pain was reported to be in the lower back area (53.6%). Age was positively related to NP: the average age in the group with NP was 22.7 years (SD ± 4.1) and in the group without NP was 19.8 years (SD ± 4.5), p < 0.05. Higher rates of NP occurred in patients aged 19 years or older, compared with that in teens (p < 0.01). There was a positive association between NP and the use of hydroxyurea (p < 0.05). An association was found between NP and sensitive neurological changes (p < 0.01). Therefore, screening for NP may result in faster and more effective diagnoses and consequently initiate appropriate treatment.
慢性疼痛状况在镰状细胞病(SCD)中的研究较少,可能被低估。本研究的目的是确定SCD患者中神经性疼痛(NP)的发生率和特征。从2015年至2016年间符合纳入标准的554名患者中选取了56名患者作为样本。使用利兹神经病理性症状和体征评估量表来检测NP。通过卡方检验、费舍尔精确检验、方差分析和克鲁斯卡尔 - 沃利斯检验,对有NP和无NP的两组患者在性别、年龄、羟基脲的使用情况以及感觉变化方面进行比较。平均年龄为20.6岁(标准差±4.6),51.8%的患者为男性,14名患者(25%)患有NP。最常见的是,疼痛报告位于下背部区域(53.6%)。年龄与NP呈正相关:有NP组的平均年龄为22.7岁(标准差±4.1),无NP组的平均年龄为19.8岁(标准差±4.5),p < 0.05。与青少年相比,19岁及以上患者中NP的发生率更高(p < 0.01)。NP与羟基脲的使用之间存在正相关(p < 0.05)。发现NP与敏感的神经学变化之间存在关联(p < 0.01)。因此,对NP进行筛查可能会带来更快、更有效的诊断,从而启动适当的治疗。