视神经脊髓炎谱系病患者疼痛的初步研究

目的初步探讨视神经脊髓炎谱系病(NMOSD)患者相关的疼痛问题。方法收集57例NMOSD患者和51例多发性硬化(MS)患者的临床资料,采用数字疼痛强度量表(NRS)对患者疼痛程度及部位进行评估,对比分析两组疼痛发生情况、严重程度、部位及治疗情况。结果 NMOSD组患者疼痛发生率明显高于MS组患者(63.16%vs.35.29%,χ2=8.359,P=0.004)。NMOSD组患者痛性痉挛发生率与MS组差异无统计学意义(24.56%vs.11.76%,χ2=2.921,P=0.087)。NMOSD组患者的疼痛评分在0~8分,以中度疼痛为主20例(55.56%)],MS组患者的疼痛评分在0~7分,以轻度疼痛为主11例(61.11%)],但两组间轻度疼痛与中重度疼痛患者比例差异无统计学意义(36.11%vs.61.11%,63.89%vs.38.89%,χ2=3.038,P=0.081)。NMOSD组16例/36例(44.44%)]及MS组6例/18例(33.33%)]患者的疼痛部位均以躯干部位最常见。Logistic逐步回归分析显示NMOSD患者的疼痛程度与患者的性别、年龄、病程、发作次数、NMO-IgG及EDSS评分无相关性。结论疼痛在NMOSD患者中十分常见,其疼痛应受到重视,并应积极对症治疗。

The study of pain in patients with neuromyelitis optica spectrum disorders

Objective To investigate the issues of pain in patients with neuromyelitis optica spectrum disorders (NMOSD) . Methods We analyzed the data of 57 patients with NMOSD and 51 patients with multiple sclerosis (MS) . The degree of pain was assessed using the numerical rating scale (NRS ) . To compare the occurrence and severity of pain ,location of pain and the treatment situation in two groups were recorded. Results Pain in NMOSD was far more common than in MS (63.16% vs .35.29% , χ2 = 8.359 , P = 0.004) . Painful tonic spasm in NMOSD (24.56% ) was more common than in MS (11.76% ) , but there was no significant difference between the two groups (χ2 = 2.921 , P = 0.087) . The severity of pain did not correlate with the duration of the disease ,age ,sex ,EDSS ,AQP4 antibody status or the number of relapses in NMOSD. The patients with NMOSD had pain scores ranging from 0 to 8 and moderately pain in 20 patients (55.55% ). In the MS group ,the pain scores were 0-7 and mild pain was in 11 patients (61.11% ) . But there was not significant difference between the two groups in mild pain and moderately / severely pain (36.11% vs. 61.11% , 63.89%vs. 38.89% , χ2 = 3.038 , P= 0.081) . The pain area was mainly in the trunk part in patients with NMOSD and MS.Conclusions Pain was highly prevalent in patients with NMOSD , and should be paid attention to and actively treated.