持续性躯体形式疼痛障碍患者的感觉门控电位P50研究

Study of the sensory gating P50 in patients with persistent somatoform pain disorder

目的研究持续性躯体形式疼痛障碍(PSPD)患者的感觉门控电位(P50)的特点。方法选取2013年9月-2014年6月就诊于四川大学华西医院心理卫生中心门诊并确诊为躯体形式疼痛障碍的患者,共64例,运用汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA-14)及疼痛数字评价量表(NRS)对64例PSPD患者进行评定;应用脑电生理仪和反应时间技术,检测这64例PSPD患者的P50,与60名健康对照组的P50进行比较。结果 PSPD组HAMD、HAMA、NRS评分分别为(37.89±10.61)分、(25.58±7.49)分、(7.09±1.51)分;PSPD组S2-P50波幅为(10.23±0.33)u V,健康对照组为(7.53±3.86)u V,差异有统计学意义(t=3.882,P=0.000);PSPD组和健康对照组P50抑制率分别为(0.53±0.19)和(0.43±0.17),差异有统计学意义(t=3.113,P<0.01);PSPD组P50异常百分率为56.25%,健康对照组为33.33%,差异有统计学差异(χ2=6.567,P=0.01)。结论PSPD患者疼痛较重,存在严重抑郁及明显焦虑;PSPD患者的P50抑制异常百分率较高,S2-P50波幅增高,P50抑制率增高,PSPD患者存在感觉门控功能缺损。

Objective To explore the features of the sensory gating potentials（P50） in patients with Persistent Somatoform Pain Disorder（ PSPD） and healthy adults. Methods We Select 64 patients who visited the Mental Health Center, West China Hospital of Sichuan University and been diagnosed with PSPD from September 2013 to June 2014. The 24 -item Hamilton Depression Scale （HAMD-24）,the 14-item Hamilton Anxiety Scale （HAMA-14）,the Numerical Rating Scale were assessed in 64 patients with PSPD;The sensory gating potentials P50 was measured in 64 patients with PSPD and 60 healthy controls（ HC） by brain electrical physi-ological instrument and reaction time. Results The HAMD-24 scores were （37. 89 ± 10. 61）, the HAMA-14 scores were （25. 58 ±7.49）, the NRS scores were （7.09 ±1.51）;PSPD group showed increased S2-P50 amplitude （PSPD：（10.23 ±0.33）uV, HC：（7.53±3.86）uV, P=0.000）; PSPD group showed Increased P50 inhibition rate（PSPD：0.53 ±0.19,HC：0.43 ±0.17, P 〈0. 01）;There was significant difference in the rate of P50 inhibit abnormal between the two groups （PSPD：56. 25%,HC：33. 33%,χ^26. 567,P=0. 01）. Conclusion The pain and depression and anxiety of the patients of PSPD were heavy. The function of sensory gating in patients with PSPD is broken.