术后系统性炎症标志物在椎管内神经鞘瘤术后神经病理性疼痛的预测作用研究  

The predictive effect of post-operative biomarkers of systemic inflammation on neuropathic pain in patients of spinal cord nerve sheath tumor

作　　者：李道龙 李志勇 杨振时 沈俊 张玉忠 范梦然 付为刚 LI Dao-long;LI Zhi-yong;YANG Zhen-shi;SHEN Jun;ZHANG Yu-zhong;FAN Meng-ran;FU Wei-gang(Department of Neurosurgery,Affiliated Hospital of West Anhui Health Vocational College(Lu’an Second People’s Hospital),Lu’an,Anhui 237008,China)

机构地区：[1]皖西卫生职业学院附属医院(六安市第二人民医院),安徽六安237008

出　　处：《颈腰痛杂志》2024年第2期296-300,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨术后系统性炎症标志物在椎管内神经鞘瘤术后神经病理性疼痛(neuropathic pain,NP)发生中的预测作用。方法选取2020年1月~2023年2月在皖西卫生职业学院附属医院收治并进行手术的椎管内神经鞘瘤患者59例。术后3个月时进行门诊随访,根据数字疼痛评分量表(numerical rating scale,NRS)和神经病理性疼痛量表(neuropathic pain questionnaire,NPQ)结果,将患者纳入NP组(NRS≥1分,且NPQ≥0.016分)和非NP组(NRS=0分);且根据NRS评分,将疼痛患者分为轻度疼痛(NRS 1-3分)和中重度疼痛(NRS≥4分)。采用单因素分析和回归分析方法,分析椎管内神经鞘瘤术后神经病理性疼痛的独立预测因素,从而探索术后系统性炎症标志物在术后神经病理性疼痛中的预测价值,并分析其效能。结果经过单因素分析和回归分析,发现全血淋巴细胞(P<0.001)、中性粒细胞(P=0.039)、中性粒细胞/淋巴细胞比例(P=0.032)、血小板/淋巴细胞比例(P=0.003)是椎管内神经鞘瘤术后病理性神经疼痛的独立预测因素,但是与疼痛严重程度无明显相关关系。其中,淋巴细胞、中性粒细胞/淋巴细胞比例、血小板/淋巴细胞比例具有较好的预测效能(AUC>0.8)。结论椎管内神经鞘瘤患者术后的全血淋巴细胞和中性粒细胞等系统性炎症标志物,可以作为患者术后神经病理性疼痛的独立预测因素。Objective To explore the risk factors post-operative biomarkers of systemic inflammation on neuropathic pain(NP)in patients of spinal cord nerve sheath tumor.Methods A total of 59 patients with spinal cord nerve sheath tumor receiving operative treatments were recruited from the Second People’s Hospital of Lu’an.All patients were followed up for three months after the operation.The recovery of patients was assessed by numerical rating scale and neuropathic pain questionnaire.Then the patients were classified into NP group(NRS≥1 and NPQ≥0.016)and non-NP group(NRS=0).Meanwhile the patients in NP group were then classified into mild pain group(NRS 1-3)and moderate-to-severe pain group(NRS≥4).Univariate and linear regression analyses were applied to identify the independent risk factors for NP.Results After the univariate and linear regression analyses,we found blood lymphocyte(P<0.001),neutrophil(P=0.039),neutrophil to lymphocyte ratio(P=0.032),and platelet to lymphocyte ratio(P=0.003)could independently predict the occurrence of NP,among which lymphocyte,neutrophil to lymphocyte ratio,and platelet to lymphocyte ratio had good predictive efficacies(AUC>0.8).Conclusion The post-operative biomarkers concerning the systemic inflammation could be served as independent predictive markers for NP in the patients with spinal cord nerve sheath tumor.

关 键 词：神经病理性疼痛 椎管内神经鞘瘤 系统性炎症标志物 中性粒细胞/淋巴细胞比例 血小板/淋巴细胞比例 

分 类 号：R739.42[医药卫生—肿瘤]