血清钙离子水平、神经肽Y、CX3C趋化因子受体1对带状疱疹后遗神经痛的预测价值及其与神经系统损伤的相关性分析  

Predictive value of serum calcium level, neuropeptide Y, CX3C chemokine receptor 1 on postherpetic neuralgia and their correlation with nervous system injury

作　　者：吕雪青 程祝强 刘红军 金毅 申培培 LYU Xue-qing;CHENG Zhu-qiang;LIU Hong-jun(Department of Pain,People's Liberation Army Eastern Theater Command General Hospital,Nanjing Jiangsu 210000,China.)

机构地区：[1]解放军东部战区总医院疼痛科,江苏南京210000 [2]解放军东部战区总医院麻醉科,江苏南京210000

出　　处：《临床和实验医学杂志》2023年第19期2057-2061,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省科学技术厅社会发展—医药项目(编号:BE2021728)。

摘　　要：目的探讨血清钙离子水平、神经肽Y、CX3C趋化因子受体1(CX3CR1)对带状疱疹后遗神经痛(PHN)的预测价值及其与神经系统损伤的相关性。方法回顾性选取2019年3月到2022年3月解放军东部战区总医院收治的60例带状疱疹患者作为研究对象进行分析,将其作为观察组,对所有患者分别给予镇痛药物、抗惊厥药物以及抗菌药物进行常规治疗,并在治疗2个月后对所有患者进行疼痛数字评分量表(NRS)评分,将NRS评分≥4分,且将向相邻区域或皮肤病区域出现持续性疼痛的23例患者设为PHN组,将其余37例患者设为非PHN组,对比两组患者一般临床资料与治疗前钙离子、神经肽Y、CX3CR1水平,并应用Logistic回归分析钙离子、神经肽Y、CX3CR1对PHN的预测价值。60例带状疱疹患者治疗6个月后对其进行QST诊断,并选取同期体检的60名健康者作为对照组,对比观察组与对照组患者定量感觉测试(QST)诊断结果,并对比两组患者治疗后钙离子、神经肽Y、CX3CR1水平,分析钙离子、神经肽Y、CX3CR1与QST诊断结果的相关性,随后建立受试者工作特征(ROC)曲线,分析钙离子、神经肽Y、CX3CR1对PHN神经系统损伤的诊断效能。结果PHN组与非PHN组患者性别构成比、年龄、体重指数、合并冠心病、高血压、发病部位比较,差异均无统计学意义(P>0.05),PHN组患者合并糖尿病患者比率,坏疽型或出血型患者比率,NRS评分,治疗前的神经肽Y、CX3CR1水平均高于非PHN组,治疗前的钙离子水平低于非PHN组,差异均有统计学意义(P<0.05)。Logistic回归分析结果表明,治疗前钙离子、神经肽Y、CX3CR1为PHN的独立影响因素(P<0.05)。治疗后,观察组热痛觉、冷痛觉、温觉、冷觉、神经肽Y、CX3CR1高于对照组,钙离子低于对照组,差异均有统计学意义(P<0.05)。采用Spearman相关法分析神经系统损伤QST诊断各因子与钙离子、神经肽Y、CX3CR1表达水平的相关性。结果显�Objective To investigate the predictive value of serum calcium level,neuropeptide Y(NPY),CX3C chemokine receptor 1(CX3CR1)on postherpetic neuralgia(PHN)and their correlation with nervous system injury.Methods Sixty patients with postherpetic neuralgia admitted to People's Liberation Army Eastern Theater Command General Hospital from March 2019 to March 2022 were selected as the study subjects for analysis.They were divided into an observation group,and all patients received routine treatment with analgesics,anticonvulsants,and antibiotics.After two months of treatment,all patients were scored on the Pain Digital Rating Scale(NRS),with an NRS score of≥4,23 patients who experienced persistent pain in adjacent areas or skin disease areas were divided into the PHN group,and the remaining 37 patients were divided into the non PHN group.The general clinical data of the two groups of patients were compared with the expression levels of calcium,NPY,and CX3CR1 before treatment,and the predictive value of calcium,NPY,and CX3CR1 for PHN was analyzed using logistic regression.After 6 months of treatment,60 PHN patients were diagnosed with QST,and 60 healthy individuals who underwent physical examination at People's Liberation Army Eastern Theater Command General Hospital were selected as the matched group.The quantitative sensory testing(QST)diagnostic results of the observation group and the matched group were compared,and the expression levels of calcium,NPY,and CX3CR1 were compared between the two groups of patients after treatment.The correlation between calcium,NPY,CX3CR1 and QST diagnostic results was analyzed,and a receiver operating characteristic(ROC)curve was established.To analyze the diagnostic efficacy of calcium,NPY,and CX3CR1 in the diagnosis of neurological damage in PHN.Results The gender composition ratio,age,body mass index,combined coronary heart disease,hypertension,and site of onset of disease were compared between patients in the PHN group and the non-PHN group,and the differences were not statistica

关 键 词：钙离子 神经肽Y CX3C趋化因子受体1 带状疱疹后遗神经痛 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]