Lucantoni C, Caimmi L, Marinelli S, Refe A, Tommasini P F, Gaetti R
Divisione Cardiologia, Medicina Geriatrica, INRCA-Ancona.
Minerva Med. 1996 Dec;87(12):577-84.
The increase in pain threshold is one of the most significant hypothesis regarding the origin of silent ischaemic cardiopathy. The relations between silent ischaemia and aging aren't clear, although age is considered a risk factor in this pathology, in relation to a supposed peripheral neuropathy. In our study we evaluated the trend of pain threshold and of pain tolerance in subjects affected by silent ischaemic cardiopathy; we especially considered the role of aging. We studied 15 subjects with silent ischaemic cardiopathy and 15 with symptomatic cardiopathy; we evaluated the pain threshold and tolerance in three points using short and low frequency transcutaneous electrical impulses. All subjects were male; the exclusion criterion was a high level of anxiety and depression. Pain threshold values were measured with the same method in 40 healthy subjects, 5 per each decade and ranged from 10 to 90 years. Our data show a significant difference in pain threshold and tolerance between subjects affected by silent and non silent cardiopathy (33.9 +/- 12.9 mA vs 25.0 +/- 12.6 mA: p = 0.001 in the comparison of thresholds, and 66.8 +/- 20.9 mA vs 45.0 +/- 21.8: p = 0.000 in the comparison of tolerances). Regarding the higher significance of our data, compared with other studies, we considered the importance of our particular stimulation method and of the uniformity of the studied group. We didn't note any correlation between pain threshold and age. These data suggest that the differences evident between subjects with silent and symptomatic cardiopathy are linked to a different modulation of central pain perception uncorrelated with age.
疼痛阈值的升高是关于无症状性缺血性心脏病发病机制的最重要假说之一。尽管年龄被认为是这种病理状态下的一个危险因素,与推测的周围神经病变有关,但无症状性缺血与衰老之间的关系尚不清楚。在我们的研究中,我们评估了无症状性缺血性心脏病患者的疼痛阈值和疼痛耐受性趋势;我们特别考虑了衰老的作用。我们研究了15例无症状性缺血性心脏病患者和15例有症状性心脏病患者;我们使用短程和低频经皮电刺激在三个点评估疼痛阈值和耐受性。所有受试者均为男性;排除标准是焦虑和抑郁程度较高。用相同方法在40名健康受试者中测量疼痛阈值,每十年5名,年龄范围为10至90岁。我们的数据显示,无症状性和有症状性心脏病患者之间在疼痛阈值和耐受性方面存在显著差异(阈值比较:33.9±12.9 mA对25.0±12.6 mA,p = 0.001;耐受性比较:66.8±20.9 mA对45.0±21.8 mA,p = 0.000)。鉴于我们的数据与其他研究相比具有更高的显著性,我们考虑了我们特殊刺激方法和研究组一致性的重要性。我们未发现疼痛阈值与年龄之间存在任何相关性。这些数据表明,无症状性和有症状性心脏病患者之间明显的差异与与年龄无关的中枢性疼痛感知的不同调节有关。