Kedyk Ivan, Stanislavchuk Mykola
Department of Internal Medicine No. 1, National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
Reumatologia. 2023;61(2):104-108. doi: 10.5114/reum/163223. Epub 2023 May 10.
Neuropathic pain (NP) in ankylosing spondylitis (AS) is an important factor that complicates patients' everyday activities and leads to a decrease of life quality. Detection and diagnosis of NP can be facilitated by the use of screening instruments, and the comparative assessment of the sensitivity of different scales is important for improving the diagnosis and personalizing the treatment of AS.The aim of the study was to analyze prevalence of NP in patients with AS and clinical features of AS patients depending on the presence of NP.
We examined 94 patients with NP and 48 patients without pain in AS using the following questionnaires: LANSS, DN4, StEP, BASFI, BASMI, BASDAI, HAQ, ASAS HI/EF and BAS-G.
The prevalence of NP according to LANSS was 51.7% in women and 32.7% in men ( = 0.048); according to DN4 - 58.6% and 32.7%, respectively ( = 0.010). Disease activity and functional disability of the patients were higher in the group of patients with NP than in the group of patients without NP according to the BASDAI, BASFI, BASMI, HAQ, ASAS HI/EF and BAS-G. Significance of differences between groups was at the level of < 0.01.
The prevalence of NP in AS is alarmingly high. Even with low scores on screening scales, patients showed signs of NP, which may indicate higher prevalence of NP. Neuropathic pain is more associated with the activity of the disease, greater loss of functional capacity and a decrease in indicators of the general state of health, which allows it to be considered as an aggravating factor regarding these manifestations.
强直性脊柱炎(AS)中的神经性疼痛(NP)是使患者日常活动复杂化并导致生活质量下降的重要因素。使用筛查工具有助于神经性疼痛的检测和诊断,不同量表敏感性的比较评估对于改善AS的诊断和治疗个体化很重要。本研究的目的是分析AS患者中NP的患病率以及根据NP的存在情况分析AS患者的临床特征。
我们使用以下问卷对94例AS合并NP的患者和48例无疼痛的AS患者进行了检查:LANSS、DN4、StEP、BASFI、BASMI、BASDAI、HAQ、ASAS HI/EF和BAS-G。
根据LANSS,女性NP患病率为51.7%,男性为32.7%(P = 0.048);根据DN4,分别为58.6%和32.7%(P = 0.010)。根据BASDAI、BASFI、BASMI、HAQ、ASAS HI/EF和BAS-G,NP患者组的疾病活动度和功能残疾程度高于无NP患者组。组间差异的显著性水平为P < 0.01。
AS中NP的患病率高得惊人。即使筛查量表得分较低,患者也表现出NP迹象,这可能表明NP患病率更高。神经性疼痛与疾病活动、功能能力的更大丧失以及总体健康状况指标的下降更相关,这使其可被视为这些表现的加重因素。