Spontaneous onset of Complex Regional Pain Syndrome
Spontaneous onset of Complex Regional Pain Syndrome
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DOI：
10.1016/j.ejpain.2009.08.007
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发表时间：
2010-05-01
影响因子：
3.6
通讯作者：
Marinus, Johan
中科院分区：
文献类型：
--
作者：
de Rooij, Annetje M.;Perez, Roberto S. G. M.;Marinus, Johan
复杂区域疼痛综合征(CRPS)通常发生在伤害事件之后，但有3-11%的病例是自发性起病。自发性CRPS的存在一直备受争议，因此本研究的目的是比较自发性CRPS患者和外伤性CRPS患者的表型特征。分析了在四个麻醉科随访的537名CRPS患者的数据，其中498名(93%)患者有已知的诱发事件，39名(7%)患者没有已知的诱发事件。两组患者的性别、发病部位在上肢或下肢、左侧或右侧无显著差异。与创伤诱发的CRPS患者相比，自发性患者在发病时平均年轻9岁，中位病程长1.4年。当控制多重测试的效果时，34个比较的体征和症状中的任何一个在频率上都没有发现显著差异。综上所述，慢性阻塞性肺疾病可能伴有或不伴有诱发性有害事件，两组患者的临床表现大体相似。自发起病的CRPS患者通常在较小的年龄就会出现这种综合征，这可能表明他们更容易患上这种疾病。自发性发病病例的病程较长可能反映出发病过程更缓慢、预后更差或诊断延迟，这可能是由于在没有明确的始发事件的情况下不愿做出这种诊断的结果。(C)2009年欧洲国际疼痛研究协会联合会。爱思唯尔有限公司出版。保留所有权利。
Complex Regional Pain Syndrome (CRPS) usually develops after a noxious event, but spontaneous onsets have been described in 3-11% of the cases. The existence of spontaneous-onset CRPS is highly debated and the aim of the present study was therefore to compare the phenotypic characteristics of CRPS patients with a spontaneous onset, with those of patients with a trauma-induced onset.Data of 537 CRPS patients followed up at four departments of anesthesiology were analyzed and comprised 498 (93%) patients with and 39 (7%) patients without a known eliciting event. There where no significant differences between the two groups in gender, or in onset in upper or lower limb or left or right side of the body. Compared to CRPS patients with a trauma-induced onset, spontaneous-onset cases were on average 9 years younger at disease onset and had a 1.4 years longer median disease duration. No significant differences in frequency were found for any of the 34 compared signs and symptoms when the effect of multiple testing was controlled. In conclusion, CRPS may develop both with and without a precipitating noxious event, with both groups exhibiting a largely similar clinical presentation. Spontaneous-onset CRPS patients generally develop the syndrome at a younger age, possibly indicating a susceptibility to develop the condition. The longer disease duration in spontaneous-onset cases may reflect a more gradual disease onset, poorer prognosis, or a delay in diagnosis, possibly as a result of reluctance to make this diagnosis in the absence of a clear initiating event. (C) 2009 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.