我国3省市门诊中老年慢性疼痛病人的流行特征分析  

Epidemic characteristics analysis of outpatient middle-aged and elderly chronic pain patients in 3 provinces and cities in China

作　　者：杜成欣 张伟伟[1] 许丽媛[2] 樊碧发[2] 董建群[1] 颜流霞[1] 姜莹莹[1] DU Cheng-xin;ZHANG Wei-wei;XU Li-yuan;FAN Bi-fa;DONG Jian-qun;YAN Liu-xia;JIANG Ying-ying(National Center for Chronic and Noncommunicable Diseases Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Department of Pain,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京2100050 [2]中日友好医院疼痛科,北京100029

出　　处：《中国疼痛医学杂志》2024年第5期341-347,共7页Chinese Journal of Pain Medicine

基　　金：国家重点研发计划项目(2022YFC3602204)。

摘　　要：目的:调查了解我国3省市门诊中老年慢性疼痛病人流行特征。方法:2023年4月至8月采用多阶段分层抽样方法,在北京市、重庆市、江西省各抽取1家三级甲等综合医院和二级甲等综合医院,纳入年龄≥45岁、主诉疼痛时间持续超过3个月的门诊慢性疼痛病人。通过问卷调查了解调查对象的一般情况和慢性疼痛流行特征。计数资料用率表示,采用秩和检验分析单向有序资料,趋势χ^(2)检验分析双向有序资料,采用二元logistic回归分析病人疼痛程度的影响因素。结果:纳入分析的有效样本为4151例,其中男性1803例(43.4%)、女性2348例(56.6%);45~64岁2193例(52.8%)、≥65岁1958例(47.2%)。疼痛轻、中、重度分别为1079例(26.0%)、2535例(61.1%)、537例(12.9%)。慢性疼痛病人的疼痛程度在年龄(χ^(2)=39.061,P<0.001)、东中西部地区(Z=768.542,P<0.001)、城乡地域(Z=-10.513,P<0.001)、文化程度(χ^(2)=4.280,P<0.05)、家庭年收入(χ^(2)=26.707,P<0.001)、是否有既往病史(Z=-3.685,P<0.001)、饮酒状况(χ^(2)=10.172,P<0.01)、疼痛年限(χ^(2)=12.617,P<0.001)、疼痛部位数量(χ^(2)=106.442,P<0.001)的比较中差异有统计学意义(P<0.05)。二元logistic回归分析结果显示,年龄≥65岁(OR=1.69,95%CI:1.38-2.07)、居住在农村地域(OR=2.09,95%CI:1.58-2.77)、文化程度大专及以上(OR=1.48,95%CI:1.10-2.00)、疼痛部位数量≥2处(OR=1.73,95%CI:1.42-2.10)是重度疼痛的危险因素(P<0.05)。结论:我国3省市门诊中老年慢性疼痛病人以中度疼痛为主。年龄高低、城乡地域、文化程度、疼痛部位多寡是疼痛程度的重要影响因素。应尽早识别和干预相关影响因素,以便更全面地评估疼痛程度和制定个性化的治疗方案,从而改善病人疼痛治疗和管理效果。Objective:To investigate the epidemic characteristics of middle-aged and elderly chronic pain patients in outpatient department in 3 provinces and cities in China.Methods:From April to August 2023,a multi-stage stratified sampling method was used to select a tertiary class A general hospital and a secondary class A general hospital in each of Beijing,Chongqing,Jiangxi Province.Outpatient chronic pain patients aged≥45 years who complained of pain for more than 3 months were included.Questionnaire was used to collect information about the patients'general characteristics and the epidemiological features of chronic pain.Counting data is expressed in rate,the rank sum test was used to analyze the one-way ordinal data,the trend χ^(2) test was used to analyze the two-way ordinal data,binary logistic regression analysis was used to identify factors influencing the severity of pain in patients.Results:The effective samples included in the analysis were 4151 outpatients with chronic pain,of which 1803(43.4%)were male and 2348(56.6%)were female.There were 2193 cases(52.8%)aged 45-64 years and 1958 cases(47.2%)aged≥65 years.The number of patients with mild,moderate,and severe pain was 1079(26.0%),2535(61.1%),and 537(12.9%),respectively.Pain severity in patients with chronic pain was significantly different in age(χ^(2)=39.061,P<0.001),east-central-west region(Z=768.542,P<0.001),urban and rural areas(Z=-10.513,P<0.001),education level(χ^(2)=4.280,P<0.05),family annual income(χ^(2)=26.707,P<0.001),previous medical history(Z=-3.685,P<0.001),drinking(χ^(2)=10.172,P<0.01),pain duration(χ^(2)=12.617,P<0.001),number of pain sites(χ^(2)=106.442,P<0.001).Binary logistic regression analysis showed that age≥65 years old(OR=1.69,95%CI:1.38-2.07),living in rural areas(OR=2.09,95%CI:1.58-2.77),college degree or above(OR=1.48,95%CI:1.10-2.00),number of pain sites≥2(OR=1.73,95%CI:1.42-2.10),is a risk factor for severe pain(P<0.05).Conclusion:In outpatient department across three provinces and cities in China,middle-aged and

关 键 词：中老年 慢性疼痛 疼痛程度 影响因素 

分 类 号：R402[医药卫生—临床医学] R181.3