长期服用阿片类药物与痛觉过敏的相关性分析

The Correlation Analysis between Long-time Taking Opioid Medicine and Hyperalgesia

目的:通过简易定量感觉测试对阿片类药物诱发痛觉过敏(OIH)疑似患者是否为真过敏进行判定。方法:选取160例长期服用阿片类药物的疑似OIH患者为实验组(n=160),以160例健康者为对照组(n=160)。对两组患者的疼痛阈值、疼痛中值与疼痛耐受极限值进行评估。同时对受试者给予安慰剂与芬太尼,评估受试者压力性疼痛敏感度。结果:阿片药物日剂量(OME)较高与疼痛中值较低(r=-0.745,P=0.022)、疼痛耐受极限值较低(r=-0.651,P=0.011)高度相关。口服吗啡超过100 mg的患者比口服吗啡少于100 mg的患者有较低的疼痛耐受力(P=0.043)。男性患者对芬太尼制剂引起的疼痛反应更敏感。结论:阿片类药物剂量与疼痛敏感度相关,服用高剂量阿片类药物的患者明显表现更敏感。

Objective： To determine the patients with suspected opioid-induced hyperalgesia （OIH） have true allergies or not by a simple quantitative sensory testing. Methods： 160 patients with long-term use of opioids OIH suspected were selected as the experimental group （n=160）. 160 healthy peoples were taken as the control group （n=160）. The pain threshold, the median pain and pain tolerance limits of patients were evaluated in tow groups. In the mean while, the subjects received placebo and fentanyl, and their pressure pain sensitivity were evaluated. Results： High opioid daily dose oral morphine equivalents （OMEs） had close correlation with the high median pain （r=-0.745, P=0.022） and low pain tolerance limits （r=-0.651, P=0.011）. High-dose group （OMEs〉 100mg） showed lower pain tolerance （P=0.043） than low-dose group （OMEs≤ 100mg）. The male patients had more sensitive response to pain caused by fentanyl formulations. Conclusion： Opioid pain dose has correlation with pain sensitivity. The patients taking high doses of opioids appeared more sensitive.