三叉神经痛合并根区蛛网膜粘连的病毒病因学研究  

Virus etiology research of trigeminal neuralgia combining arachnoids＇ adhesion

作　　者：姬广福[1] 陈剑 李刚[3] 孙彦春 胡庆雷 

机构地区：[1]泰山医学院附属医院神经外科,山东泰安271000 [2]济宁市人民医院神经外科 [3]山东大学齐鲁医院神经外科

出　　处：《中华神经外科杂志》2011年第4期501-505,共5页Chinese Journal of Neurosurgery

摘　　要：目的 探讨原发性三叉神经痛（TN）合并根区蛛网膜粘连与HSV-1感染的关系.方法 对TN患者于显微血管减压术中见其三叉神经根区合并蛛网膜粘连者59例,取其蛛网膜作为实验组;未合并根区明显蛛网膜粘连的TN患者24例,取其蛛网膜作为病例对照组;采用PCR和Western Blot方法分别检测其HSV-1特异性DNA片段、特异性抗原,并以20例外伤患者蛛网膜做正常对照.结果 三组资料中DNA片段阳性率分别为：69%、58%和25%;实验组和病例对照组的DNA片段阳性率均高于正常对照组,且差异有统计学意义（P＜0.05）,但实验组和病例对照组相比差异无统计学意义（P＞0.05）;病毒特异性抗原阳性率分别为：51%、25%和15%,实验组病毒抗原阳性率高于病例对照组,也高于正常对照组,差异有统计学意义（P＜0.05）,而病例对照组和正常对照组相比差异无统计学意义（P＞0.05）.结论 HSV-1病毒增殖性感染可能促使TN患者三叉神经根区蛛网膜的粘连,蛛网膜组织可能是HSV-1潜伏感染的另一基地;HSV-1病毒感染可能是TN又一致病因素.Objective To assess the relationship that trigeminal neuralgia combining arachnoids＇ adhesions and herpes simplex virus type 1. Methods There are fifty nine patients with trigeminal neuralgia their trigeminal nerve root area combined arachnoids＇ adhesion, cutting their arachnoids as the experimental group. There are twenty four patients with trigeminal neuralgia their trigeminal nerve root area is not combined significant arachnoids＇ adhesion, cutting their arachnoids as the case - control group. Using polymerase chain reaction and Western blot technique to detecting the HSV - 1 specific DNA fragments and specific antigen,and cutting twenty arachnoids of the patients with Brain Trauma as the normal control group. Results The positive ratio of DNA fragments in the three group is 69% 、58% and 25% respectively. The positive ratio of DNA fragments in the experiment group and case -control group were higher than the normal control group,with statistical difference （ P 〈 0. 05 ）, but the experimental group and case -control group compared with no significant difference （ P 〉 0. 05 ）. The positive ratio of virus - specific antigen is 51%、 25 % and 15 %respectively. The positive ratio of virus - specific antigen was higher than the case - control group, also higher than the normal control group, were significantly different （ P 〈 0. 05 ）, while the case - control group and the normal control group compared with no significant differences （ P 〉 0. 05 ）. Conclusion HSV - 1 proliferating infected patients with trigeminal neuralgia may result in the arachnoids adhesion of trigeminal nerve root zone; arachnoids tissue may be another latent base of HSV - 1; HSV - 1 infection may be another pathogenic factor of trigeminal neuralgia.

关 键 词：三叉神经痛 单纯疱疹病毒1型 感染 蛛网膜粘连 聚合酶链反应 蛋白质印迹 

分 类 号：R651[医药卫生—外科学] R74[医药卫生—临床医学]