中轴型脊柱关节炎患者疼痛灾难化认知及影响因素分析被引量：10

Analysis of the perception and influencing factors of pain catastrophizing in patients with axial spondyloarthritis

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摘要目的调查中轴型脊柱关节炎患者疼痛灾难化认知水平并分析其影响因素,为临床干预提供依据。方法调查2016年7月至2019年5月就诊于广州市某三级甲等医院风湿免疫科的296例中轴型脊柱关节炎患者过去1周疼痛灾难化、疼痛强度及其影响、脊柱活动度、功能及疾病活动性评分,采用非参数秩和检验、Spearman相关分析及Logistic回归分析患者疼痛灾难化的影响因素。结果患者疼痛灾难化得分为15.0(6.0,28.0),其中70例(23.6%)患者出现疼痛灾难化倾向,得分为37.0(32.0,43.0)。患者最重、最轻、平均、当前疼痛强度和疼痛总体影响程度分别为4.0(3.0,6.0),1.0(0,3.0),3.0(2.0,4.0),2.0(1.0,3.0)和2.9(1.5,4.7),均与疼痛灾难化水平呈正相关(r=0.428,0.264,0.421,0.292,0.592;P<0.01)。Bath强直性脊柱炎计量学指数>4分、BASFI≥5分的患者,疼痛灾难化水平更高[21.5(11.5,32.5),28.0(22.0,38.0)](P<0.05)。不同疾病活动程度患者疼痛灾难化水平差异有统计学意义(Z=28.550,P<0.01)。Logistic回归分析表明平均疼痛强度[OR=2.118,95%CI(1.144,3.923)]、疼痛总体影响程度[OR=4.506,95%CI(2.339,8.680)]是患者出现疼痛灾难化的独立影响因素。结论部分中轴型脊柱关节炎患者存在疼痛灾难化倾向,疼痛灾难化水平与患者的疼痛强度及其影响、脊柱活动度、功能及疾病活动程度相关,而平均疼痛强度及疼痛总体影响程度是患者出现疼痛灾难化的高危因素。 Objective To investigate pain catastrophizing(PC)level and its influencing factors in patients with axial spondyloarthritis(axSpA)to provide basis for clinical interventions.Methods 296 patients with axSpA were recruited from a GradeⅢLevel A hospital in Guangzhou from July 2016 to May 2019.Scores of PC,pain intensity and interference,spinal mobility,functional ability,and disease activity in the past week were collected.Factors influencing PC were analyzed using nonparametric test,Spearman's correlation analysis,and logistic regression analysis.Results The total score of PC was 15.0(6.0,28.0).Seventy patients(23.6%)had the tendency of PC with total score of 37.0(32.0,43.0).The worst,least,average,and current pain intensity and the overall pain interference were 4.0(3.0,6.0),1.0(0,3.0),3.0(2.0,4.0),2.0(1.0,3.0)and 2.9(1.5,4.7),respectively,which were all positively correlated with the level of PC(r=0.428,0.264,0.421,0.292,0.592,P<0.01).Patients with scores of the Bath Ankylosing Spondylitis Metrology Index(BASMI)>4 and the Bath Ankylosing Spondylitis Functional Index(BASFI)≥5 had higher PC scores[21.5(11.5,32.5),28.0(22.0,38.0),respectively,P<0.05].There was significant difference in PC among patients with different disease activity(Z=28.550,P<0.01).Logistic regression showed that the average pain intensity[OR=2.118,95%CI(1.144,3.923)]and overall pain interference[OR=4.506,95%CI(2.339,8.680)]were the independent influential factors.Conclusion PC exists in some patients with axSpA.The level of PC is associated with pain intensity and its interference,degree of spine activity,function,and disease activity.The average pain intensity and overall pain interference are independent risk factors of PC.

作者邓诗裔何懿邓思思孙尔维李漓 Deng Shiyi;He Yi;Deng Sisi;Sun Erwei;Li Li(Department of Nursing,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China;Department of Rheumatology and Immunology,the Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China)

机构地区南方医科大学珠江医院护理部南方医科大学第三附属医院风湿免疫科

出处《中华风湿病学杂志》 CAS CSCD 北大核心 2019年第12期825-830,共6页 Chinese Journal of Rheumatology

关键词椎关节炎疼痛认知 Spondylarthritis Pain Cognition

分类号 R593 [医药卫生—内科学]

作者简介通信作者:李漓,Email:lli1@smu.edu.cn。

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