Scherer Manuela J, Kampe Sandra, Fredebeul-Beverungen Jonas, Weinreich Gerhard, Costabel Ulrich, Bonella Francesco
Department of Anaesthesiology and Pain Medicine, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Essen, Germany.
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Magdeburg, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Front Med (Lausanne). 2023 May 5;10:1147555. doi: 10.3389/fmed.2023.1147555. eCollection 2023.
Prevalence and predisposing factors for the development of thoracic pain (TP) in patients with chronic interstitial lung disease (cILD) are largely unknown. Underestimation and insufficient therapy of pain can lead to worsened ventilatory function. Quantitative sensory testing is an established tool for characterization of chronic pain and its neuropathic components. We investigated frequency and intensity of TP in cILD patients and the potential association with lung function and quality of life.
We prospectively investigated patients with chronic interstitial lung disease to analyze risk factors for the development of thoracic pain and quantify thoracic pain through quantitative sensory testing. In addition, we studied the relationship between pain sensitivity and lung function impairment.
Seventy-eight patients with chronic interstitial lung disease and 36 healthy controls (HCs) were included. Thoracic pain occurred in 38 of 78 patients (49%), most frequently in 13 of 18 (72%, = 0.02) patients with pulmonary sarcoidosis. The occurrence was mostly spontaneous and not related to thoracic surgical interventions (76%, = 0.48). Patients with thoracic pain showed a significant impairment of mental well-being ( = 0.004). A higher sensitivity to pinprick stimulation during QST can be observed in patients with thoracic pain ( < 0.001). Steroid treatment was associated with lower sensitivity within thermal ( = 0.034 and = 0.032) and pressure pain testing ( = 0.046). We observed a significant correlation between total lung capacity and thermal ( = 0.019 and = 0.03) or pressure pain sensitivity ( = 0.006 and = 0.024).
This study was performed to investigate prevalence, risk factors and thoracic pain in patients with chronic interstitial lung disease. Thoracic pain mostly occurs spontaneous as a frequent symptom, and seems to be an underestimated symptom in patients with chronic interstitial lung disease, especially those with pulmonary sarcoidosis. Timely identification of thoracic pain may allow starting symptomatic treatment at early stage, before impairment in quality of life occurs.
https://www.drks.de/drks_web/, Deutsches Register Klinischer Studien (DRKS) DRKS00022978.
慢性间质性肺疾病（cILD）患者胸痛（TP）的患病率及诱发因素大多未知。疼痛评估不足和治疗不充分会导致通气功能恶化。定量感觉测试是一种用于表征慢性疼痛及其神经病理性成分的既定工具。我们调查了cILD患者中TP的频率和强度以及与肺功能和生活质量的潜在关联。
我们前瞻性地研究了慢性间质性肺疾病患者，以分析胸痛发生的危险因素，并通过定量感觉测试对胸痛进行量化。此外，我们研究了疼痛敏感性与肺功能损害之间的关系。
纳入了78例慢性间质性肺疾病患者和36例健康对照者（HCs）。78例患者中有38例（49%）出现胸痛，其中18例结节病患者中有13例（72%，P = 0.02）最为常见。胸痛大多为自发出现，与胸外科手术无关（76%，P = 0.48）。胸痛患者的心理健康有显著损害（P = 0.004）。在定量感觉测试期间，胸痛患者对针刺刺激的敏感性更高（P < 0.001）。类固醇治疗与热觉（P = 0.034和P = 0.032）和压力痛测试（P = 0.046）中的较低敏感性相关。我们观察到肺总量与热觉（P = 0.019和P = 0.03）或压力痛敏感性（P = 0.006和P = 0.024）之间存在显著相关性。
本研究旨在调查慢性间质性肺疾病患者的患病率、危险因素和胸痛情况。胸痛大多作为一种常见症状自发出现，在慢性间质性肺疾病患者中似乎是一个被低估的症状，尤其是结节病患者。及时识别胸痛可能有助于在生活质量受损之前的早期阶段开始对症治疗。
https://www.drks.de/drks_web/，德国临床试验注册中心（DRKS）DRKS00022978 。
