三叉神经痛患者外周血Toll样受体TLR3表达与疼痛程度的相关性  

Correlation between the expression of Toll-like receptor TLR3 and the degree of pain in patients with trigeminal neuralgia

作　　者：芦磊[1] 刘磊 黄一丹[2] 李文举[1] 李亦梅[1] Lu Lei;Liu Lei;Huang Yidan;Li Wenju;Li Yimei(Department of Pain,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院疼痛科,乌鲁木齐830054 [2]新疆医科大学第一附属医院麻醉科,乌鲁木齐830054

出　　处：《脑与神经疾病杂志》2021年第5期279-283,共5页Journal of Brain and Nervous Diseases

基　　金：新疆维吾尔自治区自然科学基金项目(2017D01C367)。

摘　　要：目的观察三叉神经痛(TN)患者外周血Toll样受体3(TLR3)水平及疼痛程度,并分析外周血TLR3水平与疼痛程度的关系,以指导未来该类疾病疼痛干预方案的制定。方法选取2018年1月-2019年12月期间在新疆医科大学第一附属医院接受治疗的69例TN患者作为观察组;并选取同期于新疆医科大学第一附属医院接受治疗的67例坐骨神经痛患者作为对照组,检测患者外周血TLR3水平;使用视觉模拟评分法(VAS)评估两组疼痛程度;依据VAS评分结果将观察组患者分为轻、中、重三组,调查三组一般资料、检测实验室指标及外周血TLR3水平并比较,分析TN患者疼痛影响因素;检验外周血TLR3水平预测TN疼痛程度的价值。结果观察组外周血TLR3水平及VAS评分均高于对照组(P<0.05);69例TN患者中轻度13例、中度26例、重度30例;经单因素、多因素回归分析结果显示,外周血TLR3、IL-1β、IL-6及TNF-α过表达均是TN患者疼痛程度加重的影响因素(P<0.05),其中,外周血TLR3过表达带来的影响最显著,可能是TN患者疼痛程度加重的独立影响因素;绘制受试者工作曲线分析结果显示,外周血TLR3预测TN患者疼痛程度加重的曲线下面积(AUC)为:0.815,>0.80,预测价值较理想。结论TN患者疼痛程度加重可能与外周血TLR3过表达有关,临床可考虑通过检测TN患者外周血TLR3水平,来预测患者疼痛加重风险,以指导早期风险评估与防治,可能对减轻TN患者的疼痛程度有积极意义。Objective To observe the level of peripheral blood Toll-like receptor 3(TLR3)and the degree of pain in patients with trigeminal neuralgia(TN),and to analyze the relationship between the level of peripheral TLR3 and the degree of pain in order to guide the formulation of future pain intervention programs for such diseases.Methods From January 2018 to December 2019,69 patients with TN who were treated in the First Affiliated Hospital of Xinjiang Medical University were selected as the observation group;and 67 sciatica patients who were treated in the First Affiliated Hospital of Xinjiang Medical University during the same period were selected as the control group.Detected TLR3 level in patients’peripheral blood;the dvisual analogue scoring(VAS)was used to assess the pain level of the two groups;according to the VAS scoring results,the patients in the observation group were divided into three groups:the mild,moderate and severe groups.The three groups of general information,laboratory indicators and peripheral blood TLR3 levels were investigated and compared,and the influencing factors of patients with TN were analyzed;tested the value of peripheral blood TLR3 level to predict the degree of TN pain.Results The peripheral blood TLR3 level and VAS score of the observation group were higher than those of the control group(P<0.05);69 patients with TN were mild in 13 cases,moderate in 26 cases,and severe in 30 cases;Factors and multivariate regression analysis showed that TLR3,IL-1β,IL-6 and TNF-αoverexpression in peripheral blood were all influencing factors for the aggravation of pain in patients with TN(P<0.05),among which Peripheral blood TLR3 overexpression had the most significant effect,which may be an independent influencing factor for the aggravation of pain in patients with TN;The analysis result of drawing the receiver working curve showed that the area under the curve(AUC)of peripheral blood TLR3 to predict the aggravation of pain in patients with TN was:0.815,>0.80,and the predictive value was ideal.Conc

关 键 词：三叉神经痛 TOLL样受体3 疼痛程度 炎症因子 相关性 

分 类 号：R745[医药卫生—神经病学与精神病学]