儿童低温天气下病毒感染后双足神经痛的病例报道及原因分析  

Explosive neuropathic pain after virus infection in cold weather in children:cases report and review

作　　者：卜慧莲[1] 毛鹏[2] 孔存龙[1] 刘盼梅 李新新[1] 刘文杰 王涛[1] 刘青颖 宋鑫鑫 霍浩波 樊碧发[2] 樊肖冲[1] Bu Huilian;Mao Peng;Kong Cunlong;Liu Panmei;Li Xinxin;Liu Wenjie;Wang Tao;Liu Qingying;Song Xinxin;Huo Haobo;Fan Bifa;Fan Xiaochong(Department of Pain Management,The First Affiliated Hospital of Zhengzhou University,Zhengzhou City,Henan Province 450052,China;Department of Pain Management,China-Japan Friendship Hospital,Beijing City,100029,China)

机构地区：[1]郑州大学第一附属医院疼痛科,郑州市450052 [2]中日友好医院疼痛科,北京100029

出　　处：《中华疼痛学杂志》2024年第1期102-105,共4页Chinese Journal Of Painology

摘　　要：自2023年12月29日,郑州大学第一附属医院疼痛科陆续收治了26例病毒感染后经历低温天气出现双侧足趾神经病理性疼痛的患儿,以双侧足趾爆发性疼痛为主要表现,疼痛性质以针刺样、烧灼样疼痛最多见,视觉模拟评分(VAS)在5~9分,病程一般在2周以内。患儿入院后完善检查,双下肢肌电图,下肢血管彩超,C反应蛋白和血沉等结果均在正常范围,少数病例发现血小板-白细胞聚集物(PLA)、血小板-单核细胞聚集物(PMA)、血小板-中性粒细胞聚集物(PNA)比例增加,其中PMA比例升高较为明显,患儿经过营养神经、改善循环等对症支持治疗后,疼痛在1~3 d内明显减轻。经查阅文献,推测本次患儿出现爆发性神经病理性疼痛的原因可能跟PMA介导的微循环障碍和局部炎症反应引起的神经损伤有关,但具体的发病机制仍需进一步研究,本报道可为治疗类似患儿提供一定的临床经验和帮助。From December 29 in 2023,26 children suffering neuropathic pain in both feet after virus infection in cold weather were hospitalized in Department of Pain Management of the First Affiliated Hospital of Zhengzhou University.They mainly exhibited stabbing and burning pain in the toes in both feet.The pain score was 5-9 and the pain course was less than 2 weeks.The electroneurogram and electromyogram tests and blood vessels ultrasound examination in lower limbs had none positive finding.The blood tests were mainly negative.But in some cases,the ratio of platelet-leukocyte aggregates(PLA),platelet-monocyte aggregates(PMA),and platelet-neutrophile aggregates(PNA)in blood were increased,especially for PMA.After treatment with murine nerve growth factor,NSAIDs,tramadol,and traditional Chinese medicine,the pain in these children were relieved in 1 to 3 days.After reviewing previous studies,we hypothesized that this explosive neuropathic pain in children may be involved with PMA-associated microcirculation disfunction and local inflammation in feet,which induced reversible nerve injury.However,the underlying mechanism of this neuropathic pain need to be studied in future.This case report may provide successful method to treat similar patients and newly insight in pain study.

关 键 词：病毒感染 低温天气 神经痛 儿童 血小板-单核细胞聚集物 炎症反应 

分 类 号：R725.1[医药卫生—儿科]