目的:通过简易定量感觉测试对阿片类药物诱发痛觉过敏(OIH)疑似患者是否为真过敏进行判定.方法:选取160例长期服用阿片类药物的疑似OIH患者为实验组(n=160),以160例健康者为对照组(n=160).对两组患者的疼痛阈值、疼痛中值与疼痛耐受极限值进行评估.同时对受试者给予安慰剂与芬太尼,评估受试者压力性疼痛敏感度.结果:阿片药物日剂量(OME)较高与疼痛中值较低(r=-0.745,P=0.022)、疼痛耐受极限值较低(r=-0.651,P=0.011)高度相关.口服吗啡超过100mg的患者比口服吗啡少于100mg的患者有较低的疼痛耐受力(P=0.043).男性患者对芬太尼制剂引起的疼痛反应更敏感.结论:阿片类药物剂量与疼痛敏感度相关,服用高剂量阿片类药物的患者明显表现更敏感.%Objective:To determine the patients with suspected opioid-induced hyperalgesia (OIH) have true allergies or not by a simple quantitative sensory testing.Methods:160 patients with long-term use of opioids OIH suspected were selected as the experimental group (n=160).160 healthy peoples were taken as the control group (n=160).The pain threshold,the median pain and pain tolerance limits of patients were evaluated in tow groups.In the mean while,the subjects received placebo and fentanyl,and their pressure pain sensitivity were evaluated.Results:High opioid daily dose oral morphine equivalents (OMEs) had close correlation with the high median pain (r=-0.745,P=0.022) and low pain tolerance limits (r=-0.651,P=0.011).High-dose group (OMEs＞ 100mg) showed lower pain tolerance (P=0.043) than low-dose group (OMEs-≤ 100mg).The male patients had more sensitive response to pain caused by fentanyl formulations.Conclusion:Opioid pain dose has correlation with pain sensitivity.The patients taking high doses ofopioids appeared more sensitive.
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