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静脉内使用双膦酸盐治疗复杂性区域疼痛综合征。

Intravenous treatment with biphosphates in Complex Regional Pain Syndrome.

机构信息

Department of Orthopaedic Surgery and Traumatology. "Maggiore" Hospital of Chieri. Turin. Italy.

Department of Orthopaedic Surgery and traumatology. "Edoardo Agnelli" Hospital - Pinerolo. Italy.

出版信息

Acta Biomed. 2021 Sep 2;92(4):e2021190. doi: 10.23750/abm.v92i4.11194.

DOI:10.23750/abm.v92i4.11194
PMID:34487084
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8477097/
Abstract

Complex Regional Pain Syndrome (CRPS) is a pathological persistence of spontaneous or evoked disproportionate pain. Several drugs are employed, but only bisphosphonates seem to have good outcomes. The purpose of our research is to analyze the characteristics of the cases victims of CRPS and study the beneficial effect of the intravenous nerindronic acid sodium salt (Nerixia®), in an attempt to improve the results in this disabling disease. Materials and methods: We retrospectively examined 30 cases of CRPS that had undergone intravenous nerindronic acid sodium salt therapy in our center. The patients were contacted after 12 months from the start of therapy and their clinical situation was assessed with Quick DASH Score. Results: The average age of our group was 59,76 years (span, 42-78), and female subjects were 84% (p-value <0.05). 72% of all cases were complications of wrist fractures.). The Quick DASH Score (19 points are the best result, 95 the worst outcome) average was 41,1 points. The values of Quick DASH Score differed significantly (p-value <0.001) according to the age of the patient. In addition, the DASH Score values were related to the sex of the patient (p-value <0.001). Male subjects have obtained a better score. After 12 months of intravenous therapy, 52% of cases reports that they still have joint stiffness. The DASH values differed significantly depending on the onset of intravenous treatment (p-value <0.001). Conclusion: Our study showed that the CRPS affects a population between 42 and 78 years, especially women. Treatment with intravenous bisphosphonates seems to lead to an improvement in CRPS symptoms, in particular administration between 3 and 6 months after the onset of the disease. In particular, women over 61 years of age seem to have a lower improvement in symptomatology after treatment. 52% of cases report that they still have joint stiffness.

摘要

复杂性区域疼痛综合征(CRPS)是一种自发或诱发的不成比例的疼痛病理性持续存在。有几种药物被使用,但只有双膦酸盐似乎有较好的结果。我们研究的目的是分析 CRPS 患者的病例特征,并研究静脉内奈立膦酸钠(Nerixia®)的有益效果,试图改善这种致残性疾病的结果。

材料和方法

我们回顾性检查了在我们中心接受静脉内奈立膦酸钠治疗的 30 例 CRPS 病例。在治疗开始后 12 个月与患者联系,并使用快速 DASH 评分评估他们的临床情况。

结果

我们组的平均年龄为 59.76 岁(范围,42-78 岁),女性占 84%(p 值<0.05)。所有病例中有 72%是手腕骨折的并发症。快速 DASH 评分(19 分是最好的结果,95 分是最差的结果)平均为 41.1 分。快速 DASH 评分值根据患者的年龄差异显著(p 值<0.001)。此外,DASH 评分值与患者的性别有关(p 值<0.001)。男性患者获得了更好的评分。静脉治疗 12 个月后,52%的病例报告仍有关节僵硬。DASH 值根据静脉治疗的开始时间差异显著(p 值<0.001)。

结论

我们的研究表明,CRPS 影响 42 至 78 岁之间的人群,尤其是女性。静脉内双膦酸盐治疗似乎可改善 CRPS 症状,特别是在疾病发作后 3 至 6 个月内给药。特别是 61 岁以上的女性在治疗后症状改善较低。52%的病例报告仍有关节僵硬。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2df/8477097/f8074e2c1aed/ACTA-92-190-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2df/8477097/755df08159f4/ACTA-92-190-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2df/8477097/007f0471f9b8/ACTA-92-190-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2df/8477097/f8074e2c1aed/ACTA-92-190-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2df/8477097/755df08159f4/ACTA-92-190-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2df/8477097/007f0471f9b8/ACTA-92-190-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2df/8477097/f8074e2c1aed/ACTA-92-190-g003.jpg

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