Endometriosis is associated with central sensitization: A psychophysical controlled study
Endometriosis is associated with central sensitization: A psychophysical controlled study
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DOI：
10.1016/s1526-5900(03)00720-x
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发表时间：
2003-09-01
期刊：
影响因子：
4
通讯作者：
Arendt-Nielsen, L
中科院分区：
文献类型：
--
作者：
Bajaj, P;Bajaj, P;Arendt-Nielsen, L
子宫内膜异位症是一种疼痛综合征，是育龄妇女盆腔疼痛的主要原因。本研究的目的是验证这样一种假设：与健康对照组相比，子宫内膜异位症患者持续的来自子宫内膜异位症组织的伤害性输入导致中枢敏感化，表现为躯体痛觉过敏，并增加了与实验性生理盐水诱导的肌肉疼痛有关的疼痛区域。10名经腹腔镜确诊为子宫内膜异位症的女性和10名年龄匹配的健康女性参与了这项研究。将高渗盐水(0.5mL，5.8%)随机依次注入月经痛转诊部位(下背侧多裂肌)和非疼痛控制部位(手背第一骨间肌)。子宫内膜异位症患者盐水后疼痛强度和疼痛面积明显大于对照组(P<；0.05)，但背部两组间差异无统计学意义。在子宫内膜异位症组中，背部生理盐水引起的疼痛反应没有增强，这表明生理盐水诱导的背部疼痛似乎激活了子宫内膜异位症患者的节段性抑制系统。子宫内膜异位症女性的中枢敏感化表现为肌肉伤害性感受器输入增加，表现为盐水后疼痛强度增加，FDI处疼痛区域增加，以及对压力刺激过敏。这些发现为了解与子宫内膜异位症相关的复杂疼痛机制提供了新的见解。(C)2003年，由美国疼痛协会提供。
Endometriosis is a pain syndrome representing a major cause of pelvic pain in women of reproductive age. The aim of this study was to test the hypothesis that persistent nociceptive input from endometriotic tissues leads to central sensitization manifested by somatic hyperalgesia and increased referred pain areas to experimental saline-induced muscle pain in patients with endometriosis, compared to healthy control subjects. Ten women with laparoscopically confirmed endometriosis and 10 healthy, age-matched women participated in the study. Hypertonic saline (0.5 mL, 5.8%) was injected intramuscularly, in random succession, into 1 site of menstrual pain referral (the multifidus muscle at the low back) and into 1 non-pain control site (first dorsal interosseous muscle [FDI] of the hand). The post-saline pain intensity and pain areas at the FDI were significantly greater in patients with endometriosis than in control subjects (P < .05) but were not different between the groups for the back. An absence of enhancement of post-saline pain responses at the back in the endometriosis group suggests that saline-induced pain at the back appears to activate segmental inhibitory systems in patients with endometriosis. Manifestation of central sensitization in women with endometriosis is demonstrated by increased muscle nociceptor input in the form of increased post-saline pain intensity, pain areas at the FDI, and hypersensitivity to pressure stimulation. These findings provide new insights into the complex pain mechanisms associated with endometriosis. (C) 2003 by the American Pain Society.