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系统性硬化症疼痛的常见原因:频率、严重程度及其与疾病状态、抑郁和生活质量的关系

Common Causes of Pain in Systemic Sclerosis: Frequency, Severity, and Relationship to Disease Status, Depression, and Quality of Life.

作者信息

Ostojic Predrag, Jankovic Katarina, Djurovic Nada, Stojic Biljana, Knezevic-Apostolski Sladjana, Bartolovic Daniela

机构信息

Institute of Rheumatology, Belgrade, Serbia; School of Medicine, University of Belgrade, Serbia.

Institute of Rheumatology, Belgrade, Serbia.

出版信息

Pain Manag Nurs. 2019 Aug;20(4):331-336. doi: 10.1016/j.pmn.2019.02.006. Epub 2019 May 15.

Abstract

BACKGROUND

In routine clinical practice, healthcare professionals draw little attention to pain in patients with systemic sclerosis (SSc). Pain has adverse effects on functional ability, social and emotional wellbeing.

AIMS

This study aims to assess the frequency and severity of different types of pain in patients with SSc, and the relationship of pain with disease status, depression and quality of life.

DESIGN

Consecutive patients with SSc were included in this cross-sectional study. Patients with previously diagnosed painful diseases or conditions (other rheumatic diseases, angina pectoris, neurological disorders, etc.) were excluded.

SETTINGS

Patients, who visited our rheumatology outpatient clinic from February to November 2016, participated in this study.

PARTICIPANTS/SUBJECTS: 42 consecutive patients with SSc (38 women and 4 men), mean age 56.5 years, mean disease duration 9.5 years, were included.

METHODS

All patients filled in a questionnaire, to indicate the presence or absence of some predefined pain syndromes. Disease status was assessed using the Scleroderma Assessment Questionnaire (SAQ), symptoms of depression by the Beck's Depression Inventory (BDI), whilst the quality of life was evaluated using the EuroQol questionnaire.

RESULTS

It was found that 92.9% of SSc patients suffer from different types of pain, and 45.2% of patients have pain every day. Joint pain was the most common type of pain, present in 78.6% of patients, followed by pain associated with Raynaud's phenomenon (69%), back pain (47.6%), headache (31%), chest pain (23.8%), odynophagia (21.4%) and painful digital ulcers (19%). Symptoms of neuropathic pain were noticed in 26.2% of patients. Severe joint pain, everyday pain and symptoms of neuropathic pain in SSc were associated with more severe disease and poorer quality of life. Pain related to Raynaud's phenomenon, digital ulcers, odynophagia and joint pain were associated with significant symptoms of depression.

CONCLUSION

The majority of patients with SSc suffer from different types of pain. Pain is associated with more severe disease, depression and poor quality of life.

摘要

背景

在常规临床实践中,医疗保健专业人员很少关注系统性硬化症(SSc)患者的疼痛。疼痛会对功能能力、社交和情绪健康产生不利影响。

目的

本研究旨在评估SSc患者不同类型疼痛的频率和严重程度,以及疼痛与疾病状态、抑郁和生活质量的关系。

设计

本横断面研究纳入了连续的SSc患者。排除先前诊断有疼痛性疾病或病症(其他风湿性疾病、心绞痛、神经疾病等)的患者。

地点

2016年2月至11月到我们风湿科门诊就诊的患者参与了本研究。

参与者/受试者:纳入了42例连续的SSc患者(38名女性和4名男性),平均年龄56.5岁,平均病程9.5年。

方法

所有患者填写一份问卷,以表明是否存在一些预定义的疼痛综合征。使用硬皮病评估问卷(SAQ)评估疾病状态,使用贝克抑郁量表(BDI)评估抑郁症状,同时使用欧洲生活质量问卷评估生活质量。

结果

发现92.9%的SSc患者患有不同类型的疼痛,45.2%的患者每天都有疼痛。关节痛是最常见的疼痛类型,78.6%的患者存在,其次是与雷诺现象相关的疼痛(69%)、背痛(47.6%)、头痛(31%)、胸痛(23.8%)、吞咽痛(21.4%)和疼痛性手指溃疡(19%)。26.2%的患者有神经性疼痛症状。SSc患者的严重关节痛、日常疼痛和神经性疼痛症状与更严重的疾病和更差的生活质量相关。与雷诺现象、手指溃疡、吞咽痛和关节痛相关的疼痛与明显的抑郁症状相关。

结论

大多数SSc患者患有不同类型的疼痛。疼痛与更严重的疾病、抑郁和生活质量差相关。

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