热痛阈测定可信度和灵敏度的研究

Heat pain threshold measurement:repeatability and sensitivity

目的 :研究应用MedocTSA - 2 0 0 1测定热痛阈的可信度和灵敏度。方法 :在信度研究中 ,应用限定法测定 8位正常年轻受试者的膝、踝、手及躯干部位的热痛阈 ,每周 1次 ,共 3次。采用可信度相关系数进行分析。在灵敏度的研究中 ,在 32℃— 5 0℃范围内将温度分为 10个等级 ,每 2℃为 1个等级 ,对 10位健康年青受试者的左膝进行随机刺激 ,使用视觉类比评分法将受试者对这 10个等级的温度刺激的感受记录 ,并对温度刺激强度和VAS进行相关性分析。结果 :可信度相关系数在 0 .87— 0 .95之间 ;温度刺激强度和VAS呈正性线性相关。结论 :应用MedocTSA -2 0 0 1仪器测定热痛阈的可信度和灵敏度均较高。

Objective: To systematically define the sensitivity and repeatability of heat pain threshold, using the Medoc TSA-2001 device. Method: The study on repeatability was performed on 8 young normal subjects on the knee, foot, hand and trunk, using the Method of Limits. Tests were repeated one and two weeks following the first one. In the study on sensitivity, 10 young healthy subjects performed subjective psychophysical estimates involving warm and hot cutaneous stimuli. Ten levels of temperature ranging from 32℃ to 50℃ were applied for 10 seconds to the left knee in a random order. Subjects gave continuous ratings of perceived temperature and pain intensity using the visual analogue scale (VAS). Intraclass correlation coefficient (ICC) and linear regression were used for data analysis in repeatability and sensitivity respectively. Result: ICC of the tested sites ranged from 0.87 to 0.95. There was a linear correlation between heat stimulus intensity and subjective thermal sensation, with a high value of r =0.93 and a slope of 0.54. Conclusion: Heat pain threshold measurements were not only highly repeatable but also highly sensitive. Under the present experimental paradigm, heat pain processing by the nervous system appears to be a linear function of the stimulus intensity in young humans.