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感觉表型与患有神经性疼痛患者的生活质量、功能和情感幸福感的关系。

Association of sensory phenotype with quality of life, functionality, and emotional well-being in patients suffering from neuropathic pain.

机构信息

Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany.

Inserm U987, APHP, UVSQ, Paris-Saclay University, CHU Ambroise Pare, Boulogne-Billancourt, France.

出版信息

Pain. 2022 Jul 1;163(7):1378-1387. doi: 10.1097/j.pain.0000000000002501. Epub 2021 Sep 23.

Abstract

Neuropathic pain highly affects quality of life, well-being, and function. It has recently been shown based on cluster analysis studies that most patients with neuropathic pain may be categorized into 1 of 3 sensory phenotypes: sensory loss, mechanical hyperalgesia, and thermal hyperalgesia. If these phenotypes reflect underlying pathophysiological mechanisms, they may be more relevant for patient management than underlying neurological diagnosis or pain intensity. The aim of this study was thus to examine the impact of these sensory phenotypes on mental health, functionality, and quality of life. Data of 433 patients from the IMI/EuroPain network database were analyzed, and results of HADS-D/A, Pain Catastrophizing Scale, Euro Quality of Life 5D/-VAS, Brief Pain Inventory, and Graded Chronic Pain Scale between the sensory phenotypes were compared using multiple regression analysis. There was no difference in chronic pain grade, pain intensity, depression, or anxiety scores between phenotypes. Pain interference (Brief Pain Inventory) was higher (P = 0.002); self-reported health state lower (Euro Quality of Life 5D VAS, P = 0.02); and problems regarding mobility (P = 0.008), usual activities (P = 0.004), and self-care (P = 0.039) more prominent (EQ5-D) in the sensory loss compared with the thermal hyperalgesia phenotype. Patients with sensory loss also showed higher pain catastrophizing scores (P = 0.006 and 0.022, respectively) compared with the 2 other groups. Sensory phenotype is associated with the impact of neuropathic pain conditions on well-being, daily functionality, and quality of life but is less associated with pain intensity. These results suggest that the somatosensory phenotype should be considered for personalized pain management.

摘要

神经病理性疼痛严重影响生活质量、幸福感和功能。基于聚类分析研究最近表明,大多数神经病理性疼痛患者可分为 3 种感觉表型之一:感觉缺失、机械性痛觉过敏和热痛觉过敏。如果这些表型反映了潜在的病理生理机制,它们可能比潜在的神经诊断或疼痛强度更能反映患者的管理情况。因此,本研究旨在探讨这些感觉表型对心理健康、功能和生活质量的影响。对 IMI/EuroPain 网络数据库中的 433 名患者的数据进行了分析,并使用多元回归分析比较了感觉表型之间 HADS-D/A、疼痛灾难化量表、欧洲生活质量 5D/-VAS、简明疼痛量表和分级慢性疼痛量表的结果。表型之间的慢性疼痛等级、疼痛强度、抑郁或焦虑评分无差异。疼痛干扰(简明疼痛量表)更高(P=0.002);自我报告的健康状况更差(欧洲生活质量 5D VAS,P=0.02);与热痛觉过敏表型相比,移动(P=0.008)、日常活动(P=0.004)和自我护理(P=0.039)方面的问题更突出(EQ5-D)。与其他两组相比,感觉缺失患者的疼痛灾难化评分也更高(分别为 P=0.006 和 0.022)。感觉表型与神经病理性疼痛状况对幸福感、日常功能和生活质量的影响有关,但与疼痛强度的关系较小。这些结果表明,体感表型应考虑用于个性化疼痛管理。

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