2025 年第 8 期 第 20 卷

风湿病患者疼痛的临床特征分析

Clinical characteristics analysis of pain in patients with rheumatic diseases

作者：苗婕妤申悦罗丽平赵旭马伶俐徐胜前

英文作者：Miao Jieyu Shen Yue Luo Liping Zhao Xu Ma Lingli Xu Shengqian

单位：安徽医科大学第一附属医院风湿免疫科，合肥230022

英文单位：Department of Rheumatology and Immunology the First Affiliated Hospital of Anhui Medical University Hefei 230022 China

关键词：风湿病；疼痛；调查

英文关键词：Rheumatism;Pain;Survey

• 摘要：

•  

  目的 分析风湿免疫科门诊患者疼痛的临床特征。方法 选取2019年1月至2022年6月安徽医科大学第一附属医院739例风湿免疫科门诊患者进行疼痛评估问卷调查。分析疼痛程度分布情况、疼痛造成睡眠障碍情况、疼痛部位情况，比较不同病种间疼痛程度（VAS评分）、疼痛部位、疼痛合并症的差异，并分析中-重度疼痛相关因素。结果  739例患者中存在疼痛者517例（70.0%），其中轻度疼痛（VAS评分1～3分）198例（26.8%），中度疼痛（VAS评分4～6分）215例（29.1%），重度疼痛（VAS评分7～10分）104例（14.1%）；由于疼痛造成睡眠障碍者245例（33.2%），其中主要包括129例（17.5%）为睡眠质量差，57例（7.7%）为入睡困难，54例（7.3%）为痛醒或早醒。因双手疼痛就诊于门诊的患者最多，为197例（26.7%），其次为膝关节痛152例（20.6%）。517例伴有疼痛的患者中合并高血压病者最多，为73例（14.1%）。存在疼痛的各病种风湿病患者间合并高血压病者比例差异有统计学意义（P<0.001）。不同病种风湿病患者间疼痛程度差异有统计学意义（P<0.001）。不同病种风湿病患者在腰背部痛、腿脚痛、臀髋部痛、膝关节痛、上肢痛和肩膀痛方面的分布比例差异均有统计学意义（均P＜0.05）。Logistic回归分析结果显示膝关节痛、腰背痛、腿脚痛、颈椎痛、肩膀痛、臀髋部痛、上肢痛均为造成中-重度疼痛的相关因素（均P<0.05）。结论  本研究中70.0%的风湿免疫科门诊患者存在疼痛，43.2%的患者存在中-重度疼痛，33.2%的患者由于疼痛造成睡眠障碍，提示应重视风湿免疫科门诊患者的疼痛问题。

• Objective To analyze the clinical characteristics of pain in rheumatology outpatients. Methods A total of 739 outpatients from the Department of Rheumatology and Immunology, the First Affiliated Hospital of Anhui Medical University from January 2019 to June 2022 were selected for pain assessment questionnaire survey. The distribution of pain degree, sleep disorders caused by pain, and pain location were analyzed. The differences of pain degree ［visual analog scale(VAS) scores］, pain location, and pain complications among different diseases were compared, and the related factors of moderate to severe pain were analyzed.Results Of the 739 patients, 517 cases (70.0%) had pain, including 198 cases (26.8%) with mild pain (VAS score 1-3), 215 cases (29.1%) with moderate pain (VAS score 4-6), and 104 cases (14.1%) with severe pain (VAS score 7-10). Among the 739 patients, 245 cases (33.2%) had sleep disorders caused by pain, mainly included 129 cases (17.5%) had poor sleep quality, 57 cases (7.7%) had difficulty falling asleep, and 54 cases (7.3%) woke up with pain or woke up early. Totally 197 patients (26.7%) were in the outpatient clinic due to pain in both hands, followed by 152 patients (20.6%) with knee pain. Among 517 patients with pain, 73 cases (14.1%) were complicated with hypertension. There was a statistically significant difference in the proportion of hypertension among the diseases with pain (P<0.001). There was a statistically significant difference in the degree of pain between patients with rheumatic diseases of different diseases (P<0.001). There were statistically significant differences in the distribution proportions of low back pain, leg pain, hip pain, knee pain, upper limb pain, and shoulder pain among rheumatic patients with different diseases(all P<0.05). Logistic regression analysis showed that knee pain, low back pain, leg and foot pain, cervical pain, shoulder pain, hip and hip pain, and upper limb pain were the relevant factors causing moderate to severe pain (all P<0.05). Conclusion In this study, 70.0% of outpatients in rheumatology and Immunology Department had pain, 43.2% of patients had moderate to severe pain, and 33.2% of patients had sleep disorders due to pain, suggesting that we should pay attention to the pain of outpatients in rheumatology and Immunology Department.