Kılıç Özlem, Kaya Mehmet Nur, Canbaş Muhammed, Çınar Muhammet, Yılmaz Sedat
Rheumatology Department, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Med Princ Pract. 2025 Mar 21:1-12. doi: 10.1159/000545343.
This study aimed to identify a pain phenotype associated with hypervigilance in systemic sclerosis (SSc) and evaluate possible variables that influence pain hypervigilance symptoms.
This cross-sectional, observational study included healthy controls (HCs) and SSc patients diagnosed with a score of 9 or higher according to the 2013 American College of Rheumatology-European League against Rheumatism classification criteria. The pain hypervigilance symptoms were evaluated using the central sensitization inventory (CSI), while disease activity was assessed using the European Scleroderma Research Group Activity Index (EScSG-AI). Patients were classified by CSI scores. Comparatives were done.
A total of 51 SSc patients (92.2% female, mean age [50.54 years]) and 45 HCs (88.9% female, mean age [52.62]) were included. Education and monthly income were lower for SSc than HCs (p < 0.05). The CSI score ≥40 proportion was 56.9% in SSc and 15.6% in HCs (p < 0.001). Depression-Anxiety-Stress Scale (DASS-21), Epworth Sleepiness Scale (ESS), Global Pittsburgh Sleep Quality Index (PSQI), and EuroQol Five-Dimensional Three-Level Questionnaire (EQ-5D-3L) scores were higher in SSc than HCs (p < 0.05). By using multiple linear regression analysis to determine predictors of CSI score ≥40, the effective variable was EScSG-AI. In multivariate logistic regression analysis, educational level and global PSQI scores were factors associated with CSI score ≥40 in SSc.
CSI score was positively associated with depression, disease activity, stress, anxiety, and poor sleep quality, while it was negatively associated with education and economic status. Pain hypervigilance may affect organ involvement and functioning in SSc. Clinicians should examine its biopsychosocial components.
本研究旨在确定系统性硬化症（SSc）中与过度警觉相关的疼痛表型，并评估影响疼痛过度警觉症状的可能变量。
这项横断面观察性研究纳入了健康对照者（HCs）以及根据2013年美国风湿病学会-欧洲抗风湿病联盟分类标准诊断评分为9分或更高的SSc患者。使用中枢敏化量表（CSI）评估疼痛过度警觉症状，同时使用欧洲硬皮病研究组活动指数（EScSG-AI）评估疾病活动度。根据CSI评分对患者进行分类，并进行比较。
共纳入51例SSc患者（92.2%为女性，平均年龄[50.54岁]）和45例HCs（88.9%为女性，平均年龄[52.62岁]）。SSc患者的教育程度和月收入低于HCs（p<0.05）。SSc患者中CSI评分≥40的比例为56.9%，HCs中为15.6%（p<0.001）。SSc患者的抑郁-焦虑-压力量表（DASS-21）、爱泼华嗜睡量表（ESS）、匹兹堡睡眠质量指数（PSQI）和欧洲五维健康量表（EQ-5D-3L）评分高于HCs（p<0.05）。通过多元线性回归分析确定CSI评分≥40的预测因素，有效变量为EScSG-AI。在多因素logistic回归分析中，教育水平和PSQI总分是SSc患者中与CSI评分≥40相关的因素。
CSI评分与抑郁、疾病活动度、压力、焦虑和睡眠质量差呈正相关，而与教育程度和经济状况呈负相关。疼痛过度警觉可能影响SSc患者的器官受累情况和功能。临床医生应检查其生物心理社会组成部分。
