患有阿片类药物使用障碍史的患者的过敏症:系统性审查和元分析
Martin Trøstheim1,2, Marie Eikemo2,3
1Kongsberg Hospital, Vestre Viken Hospital Trust, Kongsberg, Norway.
JAMA psychiatry
|August 14, 2024
概括
对阿片类药物使用障碍 (OUD) 的阿片激素治疗与增加的感冒疼痛敏感性有关. 然而,证据并不清楚地支持这种过敏症是直接由阿片类药物使用本身引起的.
科学领域:
- 疼痛研究 疼痛研究
- 药物中毒药物 药物中毒药物
- 临床心理学 临床心理学
背景情况:
- 对阿片类药物使用障碍 (OUD) 的阿片类药物治疗与疼痛敏感性增加有关,称为阿片类药物诱导的过敏症.
- 患者的感冒疼痛敏感度增加通常归因于阿片类药物诱导的过敏症.
研究的目的:
- 批判性地检查将OUD患者的过敏症与他们的阿片类药物使用联系在一起的证据.
- 研究OUD患者的阿片类药物治疗和疼痛敏感性之间的关系.
主要方法:
- 在Web of Science,PubMed和Embase (2023年3月 - 2024年4月) 进行了系统的文献搜索.
- 包括的研究评估了在治疗或戒断期间患有OUD病史的患者的寒冷压力测试 (CPT) 疼痛反应.
- 采用多层随机效应模型和元回归分析来合成数据并评估关联.
主要成果:
- 分析了39项涉及1385名患者和741名对照者的研究.
- 与对照组相比,接受阿片类药物激动剂治疗的患者表现出明显较低的疼痛值和耐受性.
- 超回归没有明确支持过敏症与阿片类药物使用直接相关,可能会因偏见而高估差异.
结论:
- 为OUD接受阿片类激素治疗的患者对感冒疼痛表现出过敏.
- 与长期阿片类药物治疗相关的超痛症的确切时间和因果关系尚不清楚.
- 需要进一步的研究,以了解过敏症对患者福祉和治疗结果的影响.
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