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强直性脊柱炎患者的神经性疼痛及其与纤维肌痛、维生素D状态和药物使用的关系。

Neuropathic Pain and its Relationship With Fibromyalgia, Vitamin D Status and Medication Use in Patients With Ankylosing Spondylitis.

作者信息

Mızrak Sema, Kırnap Mehmet, Cüce İsa

机构信息

Şebinkarahisar State Hospital, Department of Physical Medicine and Rehabilitation, Giresun, Turkey.

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Erciyes University, Kayseri, Turkey.

出版信息

J Rheum Dis. 2021 Jul 1;28(3):126-132. doi: 10.4078/jrd.2021.28.3.126.

DOI:10.4078/jrd.2021.28.3.126
PMID:37475992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10324899/
Abstract

OBJECTIVE

To determine the frequency of neuropathic pain (NeP) and potentially related new factors including fibromyalgia, vitamin D and medication use in ankylosing spondylitis (AS) patients.

METHODS

In total, 102 patients with AS were prospectively enrolled in this study and evaluated for pain severity (visual analog scale, VAS), disease activity (the Bath Ankylosing Spondylitis Disease Activity Index, BASDAI), fibromyalgia and current medication use The presence of NeP was also assessed using the painDETECT questionnaire Blood samples were taken from all patients to analyze serum 25-hydroxyvitamin D and inflammatory marker levels.

RESULTS

NeP component 32 (21 [20.6%]; clearly NeP and 11 [10.8%]; mixed NeP) was present in patients with AS Compared to those without NeP, they had significantly higher VAS and BASDAI scores (p=0.022 and 0.003, respectively) In addition, there was a highly significant difference of frequency of fibromyalgia between patients with and without NeP (50.0% vs 5.7%, p<0.001) Vitamin D status and medication use were comparable for patients with and without NeP Logistic regression analysis revealed that only fibromyalgia was a significant predictor of NeP.

CONCLUSION

This study confirmed that about one-third of AS patients have the NeP component In addition, NeP was found to be associated with the frequency of fibromyalgia However, no relation was found between NeP and vitamin D status and medication use in AS.

摘要

目的

确定强直性脊柱炎(AS)患者中神经性疼痛(NeP)的发生率以及包括纤维肌痛、维生素D和药物使用等潜在相关新因素。

方法

本研究前瞻性纳入了102例AS患者,评估其疼痛严重程度(视觉模拟量表,VAS)、疾病活动度(巴斯强直性脊柱炎疾病活动指数,BASDAI)、纤维肌痛和当前药物使用情况。还使用疼痛DETECT问卷评估NeP的存在。采集所有患者的血样以分析血清25-羟维生素D和炎症标志物水平。

结果

AS患者中存在NeP成分的有32例(21例[20.6%];明确的NeP和11例[10.8%];混合性NeP)。与无NeP的患者相比,他们的VAS和BASDAI评分显著更高(分别为p = 0.022和0.003)。此外,有NeP和无NeP的患者之间纤维肌痛的发生率存在高度显著差异(50.0%对5.7%,p < 0.001)。有NeP和无NeP的患者维生素D状态和药物使用情况相当。逻辑回归分析显示,只有纤维肌痛是NeP的显著预测因素。

结论

本研究证实约三分之一的AS患者有NeP成分。此外,发现NeP与纤维肌痛的发生率相关。然而,未发现AS患者中NeP与维生素D状态和药物使用之间存在关联。

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本文引用的文献

1
Is fibromyalgia frequency increasing in axial spondyloarthritis? Association with fibromyalgia and biological therapies.纤维肌痛在中轴型脊柱关节炎中发病率是否增加?与纤维肌痛和生物治疗的相关性。
Rheumatol Int. 2020 Nov;40(11):1835-1841. doi: 10.1007/s00296-020-04670-w. Epub 2020 Aug 7.
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The prevalence of fibromyalgia in axial spondyloarthritis.纤维肌痛在中轴型脊柱关节炎中的流行率。
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Neuropathic component of low back pain in patients with ankylosing spondylitis.强直性脊柱炎患者下腰痛的神经病理性成分
Mod Rheumatol. 2021 Mar;31(2):462-467. doi: 10.1080/14397595.2020.1754322. Epub 2020 Apr 27.
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Does Vitamin D Affect Diabetic Neuropathic Pain and Balance?维生素D会影响糖尿病性神经病理性疼痛和平衡吗?
J Pain Res. 2020 Jan 16;13:171-179. doi: 10.2147/JPR.S203176. eCollection 2020.
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One year in review 2018: axial spondyloarthritis.2018 年度回顾:中轴型脊柱关节炎。
Clin Exp Rheumatol. 2019 Nov-Dec;37(6):889-898. Epub 2019 Nov 28.
6
The relationship between serum 25-hydroxyvitamin D concentration and type 2 diabetic peripheral neuropathy: A systematic review and a meta-analysis.血清25-羟维生素D浓度与2型糖尿病周围神经病变的关系:一项系统评价和荟萃分析。
Medicine (Baltimore). 2019 Nov;98(48):e18118. doi: 10.1097/MD.0000000000018118.
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The prevalence and impact of comorbid fibromyalgia in inflammatory arthritis.纤维肌痛共病在炎症性关节炎中的流行情况和影响。
Best Pract Res Clin Rheumatol. 2019 Jun;33(3):101423. doi: 10.1016/j.berh.2019.06.005. Epub 2019 Jul 17.
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Pain without inflammation in rheumatic diseases.风湿性疾病中的无炎症性疼痛。
Best Pract Res Clin Rheumatol. 2019 Jun;33(3):101439. doi: 10.1016/j.berh.2019.101439. Epub 2019 Sep 6.
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Systems Pathology of Neuropathic Pain and Fibromyalgia.神经病性疼痛和纤维肌痛的系统病理学。
Biol Pharm Bull. 2019;42(11):1773-1782. doi: 10.1248/bpb.b19-00535.
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Is Fibromyalgia Syndrome a Neuropathic Pain Syndrome?纤维肌痛综合征是一种神经病理性疼痛综合征吗?
Arch Rheumatol. 2018 Nov 30;34(2):196-203. doi: 10.5606/ArchRheumatol.2019.7244. eCollection 2019 Jun.