Lompo L D, Ouédraogo A M, Somé A, Diallo O, Napon C, Kaboré B J
CHU de Tingandogo, Unité de formation et de recherches des sciences de la santé, Université Ouaga I-Pr Joseph Ki-Zerbo, Ouagadougou, Burkina Faso.
Institut de recherche en sciences de la sante, Ouagadougou, département biologie médicale et sante publique, Ouagadougou, Burkina Faso.
Med Trop Sante Int. 2021 Feb 1;1(1). doi: 10.48327/1160-X245. eCollection 2021 Mar 31.
Few studies have been done on central post-stroke pain (CPSP) in Sub-Saharan Africa, while taking it into account would improve the quality of life of stroke survivors. The purpose of this study was to determine the prevalence of CPSP, to describe its clinical profile, to assess the quality of life of patients and to identify the factors associated with its occurrence, from a prospective hospital series in Ouagadougou, Burkina Faso.
It was a prospective, descriptive and analytical longitudinal follow-up study, conducted from January 2015 to March 2020, at the Tingandogo University Hospital, in Ouagadougou, Burkina Faso. The study involved all patients over the age of 16, consecutively hospitalized for stroke confirmed by CT and / or brain MRI, then reviewed every three months in outpatient Neurology, during at least 9 months after their stroke. The sociodemographic and clinical characteristics of the patients, the nature of the stroke, the existence of CPSP and, if applicable, its clinical characteristics, its treatment and its impact on the quality of life of the patients were recorded; a bivariate then multivariate analysis with logistic regression step by step, made it possible to search for the factors associated with the occurrence of CPSP. The significance threshold used was p < 0.05.
A total of 236 patients were collected, out of which 28 patients presented a CPSP (11.9%), after a mean duration of post-stroke follow-up of 12.9 months. Cerebral infarction, intracerebral hemorrhage and cerebral venous thrombosis accounted for 69.5%, 29.7% and 0.8% respectively. The mean age of patients with CPSP was 54.6 years, with a male predominance (53.6%). The mean time to onset for CPSP was 3.8 months after stroke. Pains such as burning (75%) and allodynia (67.8%) were the most common. The average CPSP intensity was 7.6 / 10 on the visual analog scale. Hypoaesthesia (96.4%) and paraesthesia (71.4%) were the signs or symptoms most commonly associated with CPSP. CPSP had a moderate to severe negative impact on usual work, general activity and mood of patients in 60.7%, 50% and 46.4% of patients, respectively. Amitriptyline (75%) and / or level II analgesics (60.7%,) were the most used molecules, and effective in 57% of cases. Only age ≤ 50 years was independently associated with the occurrence of CPSP (OR 2.86; p = 0.03).
CPSP affects more than 1 in 10 stroke patients and moderately to severely affects the quality of life for most of these patients. Screening and adequate management of CPSP as part of multidisciplinary post-stroke follow-up will contribute to improve the quality of life of stroke patients and will facilitate their social and professional reintegration.
撒哈拉以南非洲地区针对中风后中枢性疼痛（CPSP）的研究较少，而考虑到这一情况将改善中风幸存者的生活质量。本研究的目的是通过布基纳法索瓦加杜古的一项前瞻性医院系列研究，确定CPSP的患病率，描述其临床特征，评估患者的生活质量，并确定与其发生相关的因素。
这是一项前瞻性、描述性和分析性纵向随访研究，于2015年1月至2020年3月在布基纳法索瓦加杜古的廷安多戈大学医院进行。该研究纳入了所有16岁以上因CT和/或脑部MRI确诊为中风而连续住院的患者，然后在中风后至少9个月内，每三个月在门诊神经科进行复查。记录患者的社会人口学和临床特征、中风的性质、CPSP的存在情况（如适用）及其临床特征、治疗情况及其对患者生活质量的影响；通过逐步进行双变量然后多变量逻辑回归分析，以寻找与CPSP发生相关的因素。使用的显著性阈值为p < 0.05。
共收集了236例患者，其中28例出现CPSP（11.9%），中风后平均随访时间为12.9个月。脑梗死、脑出血和脑静脉血栓形成分别占69.5%、29.7%和0.8%。CPSP患者的平均年龄为54.6岁，以男性为主（53.6%）。CPSP的平均发病时间为中风后3.8个月。灼痛（75%）和痛觉过敏（67.8%）等疼痛最为常见。在视觉模拟量表上，CPSP的平均强度为7.6 / 10。感觉减退（96.4%）和感觉异常（71.4%）是与CPSP最常相关的体征或症状。CPSP分别对60.7%、50%和46.4%的患者的日常工作、一般活动和情绪产生中度至重度负面影响。阿米替林（75%）和/或二级镇痛药（60.7%）是最常用的药物，在57%的病例中有效。只有年龄≤50岁与CPSP的发生独立相关（OR 2.86；p = 0.03）。
CPSP影响超过十分之一的中风患者，并且对大多数此类患者的生活质量产生中度至重度影响。作为多学科中风后随访的一部分，对CPSP进行筛查和适当管理将有助于提高中风患者的生活质量，并促进他们的社会和职业重新融入。
