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中央敏感化:其在血液透析患者中的患病率及其对生活质量的影响。

Central sensitization: its prevalence and impact on quality of life among hemodialyzed patients.

机构信息

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey.

Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey.

出版信息

Ir J Med Sci. 2024 Jun;193(3):1595-1602. doi: 10.1007/s11845-023-03601-5. Epub 2024 Jan 5.

Abstract

BACKGROUND/AIM: Data on the role of central sensitization in hemodialyzed patients are scarce. The aim was to identify the impact of central sensitization on quality of life and elucidate the risk factors for the development of central sensitization in patients receiving hemodialysis.

METHODS

Central sensitization, quality of life, psychological well-being, and sleep were assessed by the Central Sensitization Inventory (CSI), abbreviated version of the World Health Organization Quality of Life Instrument (WHOQOL-BREF), Hospital Anxiety and Depression Scale (HADS), and Jenkins Sleep Evaluation Scale (JSS), respectively. The effect of central sensitization on quality of life and the predictors of the development of central sensitization were assessed by regression analyses.

RESULTS

The frequency of central sensitization was 48% in the study population (n = 100). Patients with central sensitization had significantly higher pain intensity, worse sleep quality, and more impaired psychological status (p < 0.05 for all). The CSI score negatively affected all quality of life domains on its own (p < 0.001 for all, adjusted R ranged from 0.17 to 0.47). Dialysis vintage (OR, 0.8; 95% CI, 0.7 to 1.0), pain (OR, 1.5; 95% CI, 1.1 to 2.0), JSS (OR, 1.3; 95% CI, 1.1 to 1.5), and HADS-total (OR, 1.1; 95% CI, 1.0 to 1.2) were determined as the independent risk factors for central sensitization (p < 0.05 for all).

CONCLUSION

This study confirms that given the high frequency of central sensitization and its significant negative impact on quality of life, the presence of central sensitization should be investigated in patients undergoing hemodialysis.

摘要

背景/目的:关于中枢敏化在血液透析患者中的作用的数据很少。目的是确定中枢敏化对生活质量的影响,并阐明接受血液透析患者中枢敏化发展的危险因素。

方法

通过中枢敏化量表(CSI)、世界卫生组织生活质量量表简表(WHOQOL-BREF)、医院焦虑抑郁量表(HADS)和詹金斯睡眠评估量表(JSS)分别评估中枢敏化、生活质量、心理健康和睡眠。通过回归分析评估中枢敏化对生活质量的影响以及中枢敏化发展的预测因素。

结果

研究人群(n=100)中中枢敏化的频率为 48%。有中枢敏化的患者疼痛强度明显更高,睡眠质量更差,心理状态更差(所有 p<0.05)。CSI 评分本身对所有生活质量领域均有负面影响(所有 p<0.001,调整 R 范围为 0.17 至 0.47)。透析龄(OR,0.8;95%CI,0.7 至 1.0)、疼痛(OR,1.5;95%CI,1.1 至 2.0)、JSS(OR,1.3;95%CI,1.1 至 1.5)和 HADS 总分(OR,1.1;95%CI,1.0 至 1.2)被确定为中枢敏化的独立危险因素(所有 p<0.05)。

结论

本研究证实,鉴于中枢敏化的高频率及其对生活质量的显著负面影响,应在接受血液透析的患者中调查中枢敏化的存在。

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