阿片类药物诱发痛觉过敏的研究进展

Progress of Opioid-Induced Hyperalgesia

阿片类药物是治疗各种中到重度疼痛的最常用药物。它们在缓解患者疼痛的同时，可能会使患者对某些刺激变得敏感化。这一矛盾性现象可能就是阿片类药物诱发痛觉过敏（Opioid—Induced Hyperalgesia，OIH）引起的。OIH是指使用阿片类药物后导致患者对伤害性刺激的动物实验和临床研究证实TOIH的存在。虽然OIH的发生机制至今尚未完全阐明感性增加。大量的但目前主要认为阿对疼痛传导过程的改变可能导致了OIH的发生。随着0IH发生机制研究的进展．OIH的治疗手段也日益丰富。本文就OIH的证据．可能机制及治疗策略等做一综述。

Opioids have been and continue to be used for the treatment of moderate to severe pain. In some cases, opioid administration not only induces analgesia but also may cause a paradoxical response that patients receiving opioids for the treatment of pain may actually become more sensitive to certain painful stimuli,that is, opioid-induced hyperalgesia or OIH. OIH is most broadly defined as a state of nociceptive sensitization caused by exposure to opioids. OIH has been seen in animal models, and its presence and clinical implications in patients with pain are beginning to be described. Although the precise mechanism is not yet understood, it is generally thought to result from various opioid-induced changes within pain processing structures of both the spinal cord and the brainstem that lead to sensitization of pronociceptive pathways. Several treatment strategies have the potential to minimize the development of OIH, or resolve OIH if it does occur. This article reviews the progress of OIH which including the evidence of animals and humans for OIH, possible mechanism and treatment.