贵州医科大学学报

2019, v.44;No.222(03) 346-349+355

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带状疱疹急性期患者后遗神经痛的相关因素分析
Analysis of Related Factors of Post-herpetic Neuralgia in Patients with Herpes Zoster at Acute Stage

郭玉娜;倪家骧;武百山;李岩;张海红;
GUO Yuna;NI Jiaxiang;WU Baishan;LI Yan;ZHANG Haihong;Department of Pain,Xuanwu Hospital of Capital Medical University;Department of Dermatology,Huairou Hospital;

摘要(Abstract):

目的:分析带状疱疹(HZ)急性期患者后遗神经痛的相关因素。方法:65例HZ患者根据治愈3个月内是否发生遗留神经痛分为HZ后遗神经痛组(PHN组,n=30)及单纯HN组(HN组,n=35),选取同期健康体检者35例作为对照组;分别采集PHN组、HN组入院后急性期及对照组体检时空腹静脉血,采用酶联免疫吸附法(ELISA)测定其血清肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)、神经元特异性烯醇化酶(NSE)、S100B蛋白(S100B)、白细胞介素-6(IL-6)、IL-17、β-内啡肽(β-EP)、降钙素基因相关肽(CGRP)、P物质(SP)、5羟色胺(5-HT)、神经生长因子诱导蛋白(VGF)及免疫球蛋白(IgA、IgG、IgM)水平,采用流式细胞分析仪测定其外周血T细胞亚群(CD_3~+、CD_4~+、CD_8~+)。结果:3组受试者血清TNF-α、IFN-γ、NSE、S100B、IL-6及IL-17、CGRP、SP、5-HT、VGF水平比较,PHN组> HN组>对照组,血清β-EP水平比较,PHN组 PHN组>对照组,差异有统计学意义(P <0. 05); HN组、PHN组患者CD_3~+、CD_4~+、CD_8~+显著低于对照组,CD_4~+/CD_8~+显著高于对照组(P <0. 05),但两患者组比较,差异无统计学意义(P> 0. 05)。结论:HZ急性期患者血清炎性因子、疼痛介质及机体免疫状态的异常,与PHN的发生有关。
Objective: To analyze the related factors of post-herpetic neuralgia in patients with herpes zoster( HZ) at the acute stage. Methods: Sixty-five patients with HZ were divided into HZ post-neuropathic pain group( PHN group,n = 30) and HN group( HN group,n = 35) according to whether they had residual neuralgia within 3 months of cure. Thirty-five healthy controls during the same period were collected as the control group. The fasting venous blood was collected from the control group at their medical examination,the PHN group and the HN group at the acute stage after admission. Protein specific Enzyme-linked immunosorbent assay( ELISA) kits were used to detect the serum tumor necrosis factor-α( TNF-α),interferon-gamma( IFN-γ),neuron-specific enolase( NSE),S100 B protein( S100 B),interleukin-6( IL-6),interleukin-17( IL-17),β-Endorphin( β-EP),calcitonin gene-related peptide( CGRP),substance P( SP),serotonin( 5-HT),nerve growth factor-inducing protein( VGF) and immunoglobulin( IgA,IgG,At the level of IgM),respectively. Peripheral blood T cell subsets( CD_3~+,CD_4~+,CD_8~+) were measured by flow cytometry. Results: The levels of serum TNF-α,IFN-γ,NSE,S100 B,IL-6 and IL-17,CGRP,SP,5-HT and VGF were in the order of PHN group > HN group > control group; serumβ-EP levels were in the order of PHN group < HN group PHN group > control group. The differences were statistically significant( P < 0. 05). The levels of CD_3~+T cells,CD_4~+T cells and CD_8~+T cells in HN group and PHN group were significantly lower than those in the control group,whereas the ratios of CD_4~+/CD_8~+in these two groups were significantly higher than that in the control group( P < 0. 05),but there was no significant difference between PHN group and HN groups( P > 0. 05). Conclusion: The abnormal levels of serum inflammatory factors,pain mediators and immune status in patients with HZ at the acute stage are associated with the occurrence of PHN.

关键词(KeyWords): 带状疱疹;后遗神经痛;炎性因子;疼痛介质;T细胞亚群;相关因素
herpes zoster;postherpetic neuralgia;inflammatory cytokines;pain mediator;T cell subsets;related factor

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基金项目(Foundation): 北京市卫生系统高层次卫生技术人才培养计划项目(2015-3-067)

作者(Author): 郭玉娜;倪家骧;武百山;李岩;张海红;
GUO Yuna;NI Jiaxiang;WU Baishan;LI Yan;ZHANG Haihong;Department of Pain,Xuanwu Hospital of Capital Medical University;Department of Dermatology,Huairou Hospital;

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