神经病理性疼痛患者疼痛与抑郁的相关性

Correlation between pain and depression in the patients with neuropathic pain

目的通过观察神经病理性疼痛伴抑郁患者血清炎症因子含量的变化,探讨疼痛程度与抑郁严重程度的相关性。方法收集2018年8月至2019年6月在西南医科大学附属中医医院疼痛科因神经病理性疼痛初诊的患者83例,疼痛视觉模拟评分(VAS)>4分,神经病理性疼痛史>1个月,年龄≥18岁,病种包括带状疱疹痛、三叉神经痛、糖尿病性神经痛。根据Zung抑郁自评量表(SDS)筛选出其中神经病理性疼痛合并抑郁患者32例(SDS>53分)作为神经病理性疼痛合并抑郁组(抑郁组),按照1∶1进行两组倾向性匹配,抽取与试验条件相匹配的32例患者(SDS≤53分)作为神经病理性疼痛不合并抑郁组(非抑郁组)。采用酶联免疫吸附法(ELISA)检测抑郁组和非抑郁组患者血清中CXCL1、IL-1β、IL-6、MCP-1的含量。结果两组患者性别、年龄及病种差异均无统计学意义(P均>0.05);与非抑郁组相比,抑郁组患者病程较长(t=5.58,P<0.001);与非抑郁组相比,抑郁组患者VAS评分、SDS评分及患者血清中CXCL1、IL-1β、IL-6、MCP-1含量均较高(P均<0.05)。神经病理性疼痛患者VAS评分与SDS评分呈正相关(r=0.520,P<0.05)。结论神经病理性疼痛患者疼痛程度与抑郁程度呈正相关,可能与患者体内炎症因子水平的升高有关。

Objective To observe the changes of serum inflammatory factors and depression status in patients with neuropathic pain,and to explore the correlation between the pain degree and the severity of depression.Methods A total of 83 patients with neuropathic pain were collected,visual analogue scale(VAS)>4,history of neuropathic pain>1 month,aged≥18 years old,in the Pain Department of the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University from August 2018 to June 2019.Herpes zoster neuralgia,trigeminal neuralgia,and diabetic neuralgia were included.Thirty-two patients with SDS>53 were selected in the neuropathic pain with depression group(group depression).According to 1∶1,32 patients with SDS≤53 were selected in the neuropathic pain without depression group(group non-depression).The contents of CXCL1,IL-1β,IL-6 and MCP-1 were determined in serum by enzyme-linked immunosorbent assay(ELISA)in the two groups.Results There was no significant difference in sex,age and composition of diseases between the two groups(all P>0.05).Compared with the non-depression group,the diseased course was longer in the group depression(t=5.58,P<0.001),and VAS,SDS and serum contents of CXCL1,IL-1β,IL-6 and MCP-1 were higher in the group depression(all P<0.05).There was a positive correlation between VAS and SDS in patients with neuropathic pain(r=0.520,P<0.05).Conclusion The degree of pain is positively correlated with the severity of depression in patients with neuropathic pain,and the possible mechanism is the increase of inflammatory factors.