Perez-Lloret Santiago, Rojas Gloria Meza, Menoni Maria Celia, Ruiz Gabriela, Velásquez Carolina, Rodriguez Hernán, Rey María Verónica, Cardinali And Daniel P
Pharmacology Department, Paul Sabatier University, Toulouse, France.
Clin Neuropharmacol. 2012 Jan-Feb;35(1):21-4. doi: 10.1097/WNF.0b013e31823df2dc.
Pregabalin (PGB) has been shown to improve sleep quality and health-related quality of life (HRQoL) as well as pain intensity in patients with neuropathic pain.
The objective of the study was to explore the magnitude of the correlations between changes in pain intensity, sleep quality, and HRQoL after PGB treatment.
One hundred thirty-eight patients with neuropathic pain of any origin and without an adequate response to analgesics received an 8-week treatment course of PGB in an open-label fashion. Pain intensity, sleep quality, and HRQoL outcomes were evaluated at baseline and at week 8 by means of an 11-point (0-10) numerical rating scale (NRS), the Pittsburgh Sleep Quality Index (PSQI), and the EuroQol health-state visuoanalogic scale (EQ-5D VAS) score, respectively.
At week 8, mean PGB dose was 166.7 ± 7.8 mg/d. Pain intensity NRS score, PSQI total score, and EQ-5D VAS score were improved by 66.5% ± 1.9%, 40.0% ± 3.6%, and 26.4% ± 4.7% (all P < 0.01), respectively. Correlations between percent change from baseline in pain NRS score and PSQI total score or EQ-5D VAS scores were r = 0.36 (P < 0.01, R = 0.11) and r = -0.20 (P < 0.02, R = 0.05), respectively. A multivariate logistic regression analysis disclosed that PSQI score change below the median (ie, a better outcome) was related to higher EQ-5D VAS score change (odds ratio, 2.15; 95% confidence interval, 1.09-4.25), whereas pain intensity NRS score change below the median was not (odds ratio, 1.58; 95% confidence interval,0.78-3.23).
In our study, PGB-related improvements in sleep quality and HRQoL were marginally related to reductions in pain intensity in patients with neuropathic pain. Improvement in sleep quality was a significant predictor of better HRQoL, whereas pain intensity reduction was not.
已证实普瑞巴林(PGB)可改善神经性疼痛患者的睡眠质量、健康相关生活质量(HRQoL)以及疼痛强度。
本研究的目的是探讨PGB治疗后疼痛强度、睡眠质量和HRQoL变化之间的相关程度。
138例任何病因的神经性疼痛患者且对镇痛药反应不佳者,以开放标签方式接受为期8周的PGB治疗。在基线和第8周时,分别通过11点(0 - 10)数字评分量表(NRS)、匹兹堡睡眠质量指数(PSQI)和欧洲五维度健康量表视觉模拟评分(EQ - 5D VAS)对疼痛强度、睡眠质量和HRQoL结果进行评估。
在第8周时,PGB平均剂量为166.7±7.8mg/d。疼痛强度NRS评分、PSQI总分和EQ - 5D VAS评分分别改善了66.5%±1.9%、40.0%±3.6%和26.4%±4.7%(均P<0.01)。疼痛NRS评分相对于基线的变化百分比与PSQI总分或EQ - 5D VAS评分之间的相关性分别为r = 0.36(P<0.01,R = 0.11)和r = -0.20(P<0.02,R = 0.05)。多因素逻辑回归分析显示,PSQI评分变化低于中位数(即更好的结果)与更高的EQ - 5D VAS评分变化相关(比值比,2.15;95%置信区间,1.09 - 4.25),而疼痛强度NRS评分变化低于中位数则无此相关性(比值比,1.58;95%置信区间,0.78 - 3.23)。
在我们的研究中,PGB相关的睡眠质量和HRQoL改善与神经性疼痛患者疼痛强度的降低略有相关。睡眠质量的改善是更好的HRQoL的重要预测因素,而疼痛强度的降低则不是。