Oregon Health & Science University, Portland, Oregon, USA.
University of Nevada Las Vegas School of Medicine, Las Vegas, Nevada, USA.
COPD. 2022;19(1):282-289. doi: 10.1080/15412555.2022.2081540.
Previous research has identified unexpectedly strong associations between dyspnea and pain, but the reasons remain unclear. Ascertaining the underlying biological and psychological mechanisms might enhance the understanding of the experience of both conditions, and suggest novel treatments. We sought to elucidate whether demographic factors, disease severity, psychological symptoms and biomarkers might account for the association between pain and dyspnea in individuals with COPD. We analyzed data from 301 patients with COPD who were followed in a prospective longitudinal observational study over 2 years. Measures included self-reported dyspnea and pain, pulmonary function tests, serum levels of inflammatory cytokines, measures of physical deconditioning, and scales for depression and anxiety. Analyses involved cross-sectional and longitudinal linear regression models. Pain and dyspnea were strongly correlated cross-sectionally ( = 0.77, 95% CI 0.72-0.82) and simultaneously across time ( = 0.42, 95% CI 0.28-0.56). Accounting for any of the other health factors only slightly mitigated the associations. Symptoms of pain and dyspnea thus may be fundamentally linked in COPD, rather than being mediated by common biological, psychological, or functional factors. From the patient's perspective, pain and dyspnea may be part of the same essential experience. It is possible that treatments for one condition would improve the other.
先前的研究已经确定了呼吸困难和疼痛之间出人意料的强关联，但原因仍不清楚。确定潜在的生物学和心理学机制可能会增进对这两种情况的体验的理解，并提出新的治疗方法。我们试图阐明在 COPD 患者中，人口统计学因素、疾病严重程度、心理症状和生物标志物是否可以解释疼痛和呼吸困难之间的关联。我们分析了在 2 年内进行前瞻性纵向观察研究的 301 名 COPD 患者的数据。测量包括自我报告的呼吸困难和疼痛、肺功能测试、炎症细胞因子的血清水平、身体适应不良的测量以及抑郁和焦虑量表。分析涉及横断面和纵向线性回归模型。疼痛和呼吸困难在横截面上呈强相关性（ = 0.77，95%置信区间为 0.72-0.82），并且在整个时间内同时存在相关性（ = 0.42，95%置信区间为 0.28-0.56）。考虑到其他任何健康因素，仅略微减轻了关联。因此，COPD 中的疼痛和呼吸困难症状可能在根本上是相关的，而不是由共同的生物学、心理或功能因素介导的。从患者的角度来看，疼痛和呼吸困难可能是同一基本体验的一部分。一种疾病的治疗方法可能会改善另一种疾病。
