Mechanical sensation and pain thresholds in patients with chronic arthropathies
Mechanical sensation and pain thresholds in patients with chronic arthropathies
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DOI：
10.1016/s1526-5900(03)00557-1
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发表时间：
2003-05-01
期刊：
影响因子：
4
通讯作者：
McNearney, T
中科院分区：
文献类型：
--
作者：
Hendiani, JA;Westlund, KN;McNearney, T
本研究通过使用分级von Frey单丝测量覆盖类风湿性关节炎（RA; N = 27）和骨关节炎（OA; N = 28）患者膝关节的皮肤区域中的机械感觉和疼痛阈值，并与年龄和体重匹配的正常对照受试者（Norm; N = 27）进行比较。测量视觉模拟量表（VAS疼痛）、皮肤关节温度和周长，以评估主观持续疼痛和炎症。与正常人相比，RA和OA组（1）VAS疼痛评分、关节周长和（仅RA）表面温度显著升高，（2）无害机械感觉的平均阈值显著升高（分别为0.014 +/- 0.003 vs 0.077 +/- 0.035和0.123 +/- 0.043 g）表明感觉减退和（3）疼痛阈值显著降低，表明机械性异常性疼痛（Norm vs RA和CIA分别为446.683 +/- 0 vs 285.910 +/- 40.012和322.681 +/- 34.521 g）。RA患者体内关节温度、周长和疼痛阈值显著相关。RA和CIA患者平均机械感觉的最高分数与平均疼痛阈值的最低分数映射到相同的网格区域。同时出现的感觉减退和异常性疼痛，以及感觉的反常下降和痛阈的增加，可能反映了神经元对机械刺激反应性的外周和中枢改变，并表明下行抑制系统的激活。(C)2003年，美国疼痛协会。
This study measured mechanical sensation and pain thresholds in the cutaneous field overlying the knee joints of rheumatoid arthritis (RA; N = 27) and osteoarthritis (OA; N = 28) patients, compared with age- and weight-matched normal control subjects (Norm; N = 27) by using graded von Frey monofilaments. A visual analog scale (VASpain), cutaneous joint temperature and circumference were measured for subjective ongoing pain and inflammation. Compared to Norm, RA and OA groups had (1) significantly higher VASpain scores, joint circumferences and (RA only) surface temperatures, (2) significantly increased average thresholds for innocuous mechanical sensation (0.014 +/- 0.003 vs 0.077 +/- 0.035 and 0.123 +/- 0.043 g, respectively) indicative of hypoesthesia and (3) significantly decreased pain thresholds, indicative of mechanical allodynia (446.683 +/- 0 vs 285.910 +/- 40.012 and 322.681 +/- 34.521 g for Norm vs RA and CIA, respectively). Intrapatient joint temperature, circumference, and pain threshold were significantly correlated in RA. The highest scores in average mechanical sensation mapped to the same grid region as the lowest scores in average pain thresholds in RA and CIA patients. The simultaneous hypoesthesia and allodynia, with paradoxical decrease in sensation and increased pain thresholds may reflect peripheral and central alterations in neuronal responsiveness to mechanical stimulation and suggests activation of a descending inhibitory system. (C) 2003 by the American Pain Society.