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与对照组相比,足月出生且极低出生体重或小于胎龄的早产儿的年轻人的疼痛敏感性和热探测阈值。

Pain Sensitivity and Thermal Detection Thresholds in Young Adults Born Preterm With Very Low Birth Weight or Small for Gestational Age at Term Compared With Controls.

机构信息

Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.

Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

J Pain. 2018 Aug;19(8):873-884. doi: 10.1016/j.jpain.2018.03.001. Epub 2018 Mar 21.

DOI:10.1016/j.jpain.2018.03.001
PMID:29574049
Abstract

UNLABELLED

The objective of this prospective long-term follow-up study was to investigate whether somatosensory function is altered among young adults born preterm with very low birth weight (VLBW; ≤1,500 g) or small for gestational age (SGA; <10th percentile) at term. In a blinded quantitative sensory testing protocol, we determined thermal detection, thermal pain, and pressure pain thresholds and the response to prolonged supra-threshold heat among 51 VLBW, 66 term SGA, and 86 term-born controls (birth weight ≥10th percentile) at 28 years. Self-reported chronic pain was also investigated. Except for increased sensitivity to cool in the term SGA group versus controls, we found no significant group differences regarding thermal or pain thresholds. Overall, male participants had higher pain thresholds, and no significant interactions of group and sex were observed (P > .14). Within the VLBW group, neonatal mechanical ventilation was associated with reduced sensitivity to cool, and length of mechanical ventilation correlated with lower pressure pain thresholds. The response to prolonged supra-threshold heat was similar between the groups, and the prevalence of self-reported chronic pain was not reliably different. In conclusion, low birth weight young adults were as sensitive to thermal and pain stimuli as term-born, normal birth weight controls, with the same sex differences.

PERSPECTIVE

To our knowledge, this is the first report on thermal and pain sensitivity among young adults born preterm with VLBW or SGA at term. The negative results from a comprehensive quantitative sensory testing protocol oppose previous findings of altered sensory perception among children and adolescents born preterm.

摘要

目的

本前瞻性长期随访研究旨在探究极低出生体重(VLBW;≤1500g)或足月时小于胎龄儿(SGA;<第 10 百分位数)的年轻成年人是否存在体感功能改变。采用盲法定量感觉测试方案,我们在 28 岁时,评估了 51 名 VLBW、66 名足月 SGA 和 86 名足月出生对照组(出生体重≥第 10 百分位数)的热觉检测、热痛觉和压痛觉阈值以及长时间阈上热刺激的反应。还调查了自我报告的慢性疼痛。除了足月 SGA 组较对照组对冷觉更敏感外,我们未发现热觉或痛觉阈值存在显著的组间差异。总体而言,男性参与者的痛觉阈值较高,且未观察到组间和性别间的显著交互作用(P>.14)。在 VLBW 组中,新生儿机械通气与冷觉敏感性降低有关,机械通气时间与压痛觉阈值降低相关。各组对长时间阈上热刺激的反应相似,自我报告的慢性疼痛患病率无明显差异。结论:与足月、正常出生体重对照组相比,低出生体重的年轻成年人对热刺激和痛觉刺激同样敏感,且存在相同的性别差异。

观点

据我们所知,这是第一项关于足月时极低出生体重或 SGA 出生的年轻成年人热觉和痛觉敏感性的研究报告。全面定量感觉测试方案的阴性结果与之前关于早产儿感觉感知改变的研究结果相矛盾。

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