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慢性阻塞性肺疾病患者的慢性疼痛:患病率、临床及心理影响

Chronic Pain in People With Chronic Obstructive Pulmonary Disease: Prevalence, Clinical and Psychological Implications.

作者信息

Lee Annemarie L, Goldstein Roger S, Brooks Dina

机构信息

Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada.

Department of Physical Therapy, University of Toronto, Ontario, Canada.

出版信息

Chronic Obstr Pulm Dis. 2017 May 21;4(3):194-203. doi: 10.15326/jcopdf.4.3.2016.0172.

Abstract

Although pain is a common symptom in chronic obstructive pulmonary disease (COPD), pain characteristics such as frequency, duration and type are unclear. The primary study aim was to identify these pain characteristics in individuals with COPD versus healthy control participants. The secondary aim was to explore the clinical and psychological associations with pain in those with COPD. : Participants with COPD and age and gender-matched, healthy controls completed questionnaires to elicit pain characteristics. Those with COPD also had assessments of dyspnea, health-related quality of life, psychological associations (anxiety and depression) and physical activity. Sixty-four participants with COPD (mean [standard deviation (SD)] age 71[10] , forced expiratory volume in 1 second [FEV] 38% predicted) and 64 control participants (mean [SD] age 67 [13] , FEV 91% predicted) were included. Chronic pain was more prevalent in individuals with COPD compared to control participants (41% versus 29%, =0.03). The pain was more prevalent in the chest and upper back (=0.04). COPD participants with chest or upper back pain had a higher total lung capacity (mean difference 2.0L, 95% confidence interval [CI] 0.6 to 3.0L) compared to COPD participants without pain. Greater dyspnea (<0.001), more depression (=0.02) and lower physical activity levels (=0.03) were also present in people with COPD experiencing pain. Chronic pain is common in COPD. It is associated with higher dyspnea and depression and lower physical activity.

摘要

尽管疼痛是慢性阻塞性肺疾病(COPD)的常见症状,但疼痛的特征,如频率、持续时间和类型尚不清楚。主要研究目的是确定慢性阻塞性肺疾病患者与健康对照者的这些疼痛特征。次要目的是探讨慢性阻塞性肺疾病患者疼痛的临床和心理关联。慢性阻塞性肺疾病患者以及年龄和性别匹配的健康对照者完成了问卷调查,以获取疼痛特征。慢性阻塞性肺疾病患者还进行了呼吸困难、健康相关生活质量、心理关联(焦虑和抑郁)及身体活动的评估。研究纳入了64例慢性阻塞性肺疾病患者(平均[标准差(SD)]年龄71[10]岁,1秒用力呼气量[FEV]为预测值的38%)和64例对照者(平均[SD]年龄67[13]岁,FEV为预测值的91%)。与对照者相比,慢性阻塞性肺疾病患者中慢性疼痛更为普遍(41%对29%,P = 0.03)。疼痛在胸部和上背部更为普遍(P = 0.04)。与无疼痛的慢性阻塞性肺疾病患者相比,有胸部或上背部疼痛的慢性阻塞性肺疾病患者的肺总量更高(平均差异2.0L,95%置信区间[CI]0.6至3.0L)。有疼痛的慢性阻塞性肺疾病患者还存在更严重的呼吸困难(P<0.001)、更多的抑郁(P = 0.02)和更低的身体活动水平(P = 0.03)。慢性疼痛在慢性阻塞性肺疾病中很常见。它与更严重的呼吸困难、抑郁及更低的身体活动水平相关。

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