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28例复杂性区域疼痛综合征的回顾性分析

Retrospective Analysis of 28 Cases of Complex Regional Pain Syndrome.

作者信息

Beizeng Wu, Wen Bai, Xiaoxia Li, Yanhong Huang, Shubin Qiao

机构信息

Department of Rheumatology and Immunology, Beijing Fengtai Hospital of Integrated Traditional Chinese and Modern Medicine, Beijing, China.

Department of Rheumatology and Immunology, Xuanwu Hospital Capital Medical University, Beijing, China.

出版信息

Clin Med Insights Arthritis Musculoskelet Disord. 2025 Feb 23;18:11795441251318361. doi: 10.1177/11795441251318361. eCollection 2025.

Abstract

BACKGROUND

Complex Regional Pain Syndrome (CRPS) is a chronic condition characterized by persistent pain and local autonomic dysfunction. Its exact cause remains unclear, making diagnosis and treatment challenging.

OBJECTIVE

The objective was to investigate the clinical characteristics of CRPS patients and identify risk factors influencing its onset.

DESIGN

Retrospective analysis of medical records from 28 CRPS patients, examining variables such as demographics, comorbidities, triggering events, pain duration and location, previous examinations and treatments, clinical findings, auxiliary tests, initial and follow-up treatment outcomes, symptom relief time, and degree.

METHODS

Statistical methods were used to analyze the clinical data of 28 CRPS patients, assessing general characteristics and risk factors associated with the disease.

RESULTS

Females accounted for 57.14% of the cases, with an average patient age of 57.89 years. About 82.14% of patients experienced a triggering event prior to the onset of pain. The median time to diagnosis was 4.5 months, with a maximum duration of up to 7 years. Misdiagnosis occurred in 46.43% of patients. Laboratory tests showed that 77.78% (7 of 9) had abnormal bone metabolism; among those who underwent bone density scans, 66.67% (6 of 9) had osteoporosis, whereas 11.11% (1 of 9) had reduced bone mass. X-rays of 25 patients revealed that 44% (11 of 25) had either reduced bone mass or osteoporosis, with 2 showing more severe osteoporosis on the affected side compared with the healthy side. Rheumatoid arthritis was observed in 7.14% of patients. Post-treatment, significant pain relief was noted in 26 patients.

CONCLUSION

This study helps clinicians more accurately identify and manage CRPS, reducing misdiagnosis and delayed diagnosis. In addition, the data suggest that osteoporosis and rheumatoid arthritis may be potential risk factors for CRPS.

摘要

背景

复杂性区域疼痛综合征(CRPS)是一种以持续性疼痛和局部自主神经功能障碍为特征的慢性疾病。其确切病因尚不清楚,这使得诊断和治疗具有挑战性。

目的

旨在研究CRPS患者的临床特征,并确定影响其发病的危险因素。

设计

对28例CRPS患者的病历进行回顾性分析,检查人口统计学、合并症、触发事件、疼痛持续时间和部位、既往检查和治疗、临床发现、辅助检查、初始和随访治疗结果、症状缓解时间和程度等变量。

方法

采用统计学方法分析28例CRPS患者的临床资料,评估与该疾病相关的一般特征和危险因素。

结果

女性占病例的57.14%,患者平均年龄为57.89岁。约82.14%的患者在疼痛发作前经历过触发事件。诊断的中位时间为4.5个月,最长持续时间达7年。46.43%的患者发生误诊。实验室检查显示,77.78%(9例中的7例)骨代谢异常;在接受骨密度扫描的患者中,66.67%(9例中的6例)患有骨质疏松症,而11.11%(9例中的1例)骨量减少。25例患者的X线检查显示,44%(25例中的11例)有骨量减少或骨质疏松,其中2例患侧骨质疏松比健侧更严重。7.14%的患者观察到类风湿关节炎。治疗后,26例患者疼痛明显缓解。

结论

本研究有助于临床医生更准确地识别和管理CRPS,减少误诊和延迟诊断。此外,数据表明骨质疏松症和类风湿关节炎可能是CRPS的潜在危险因素。

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