Şaş Senem, Cengiz Gizem, Kaplan Hüseyin
Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University School of Medicine, Kayseri, Turkey.
J Rheum Dis. 2023 Jul 1;30(3):176-184. doi: 10.4078/jrd.2023.0009. Epub 2023 May 2.
Despite biological drug therapy, pain remains a persistent complaint in patients with axial spondyloarthritis (axSpA). We aimed to investigate the effect of central sensitization (CS) on disease activity measures, quality of life, and clinical parameters in axSpA patients.
We consecutively recruited axSpA patients who were followed up at our rheumatology outpatient clinic, and age- and sex-matched controls in this cross-sectional study. The central sensitization inventory, douleur neuropathique 4 (DN4) questions, and 2010 American College of Rheumatology fibromyalgia (FM) diagnostic criteria were applied to all individuals. The patients' clinical parameters were recorded. The data of the patient and control groups were compared.
Of the 116 axSpA patients (57 female) and 95 controls (46 female) who participated in this study, CS was determined in 46.6% of axSpA patients and 13.7% of controls (p<0.001). Patients with CS exhibited high disease activity, and poor quality of life and functionality than without it (all p<0.001). The median CS, frequency of FM and frequency of neuropathic pain were higher in patients than in the controls (all p<0.001). CS-related conditions, including anxiety and depression, were higher in axSpA patients than in controls (both p<0.05).
The results showed that CS was common in axSpA patients, and patients with CS had higher disease activity, worse quality of life, and worse functional status than those without CS.
尽管采用了生物药物治疗,但轴性脊柱关节炎(axSpA)患者的疼痛仍然是一个持续存在的问题。我们旨在研究中枢敏化(CS)对axSpA患者疾病活动度指标、生活质量和临床参数的影响。
在这项横断面研究中,我们连续招募了在我们风湿科门诊接受随访的axSpA患者以及年龄和性别匹配的对照组。对所有个体应用中枢敏化量表、神经病理性疼痛4(DN4)问卷和2010年美国风湿病学会纤维肌痛(FM)诊断标准。记录患者的临床参数。比较患者组和对照组的数据。
在参与本研究的116例axSpA患者(57例女性)和95例对照组(46例女性)中,46.6%的axSpA患者和13.7%的对照组被确定存在CS(p<0.001)。与无CS的患者相比,有CS的患者表现出更高的疾病活动度、更差的生活质量和功能(所有p<0.001)。患者的CS中位数、FM频率和神经病理性疼痛频率均高于对照组(所有p<0.001)。axSpA患者中与CS相关的情况,包括焦虑和抑郁,高于对照组(均p<0.05)。
结果表明,CS在axSpA患者中很常见,与无CS的患者相比,有CS的患者疾病活动度更高、生活质量更差、功能状态更差。