带状疱疹患者脑脊液中趋化因子水平与神经痛的相关性分析  

Analysis of the correlation between cerebrospinal fluid chemokine levels and neuropathic pain in patients with herpes zoster

作　　者：刘盼梅 马民玉[1] 李寒冰 张燕 王晶晶 樊肖冲[1] Liu Panmei;Ma Minyu;Li Hanbing;Zhang Yan;Wang Jingjing;Fan Xiaochong(Department of Pain Management,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院疼痛科,郑州450052 [2]郑州市中心医院麻醉科,郑州450052

出　　处：《中国基层医药》2024年第8期1183-1187,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨急慢性带状疱疹(HZ)患者脑脊液中趋化因子2(CCL2)、趋化因子(C-X-C基序)配体1(CXCL1)、C-X3-C基序趋化因子配体1(CX3CL1)、趋化因子(C-X-C基序)配体10(CXCL10)的水平,及其与神经痛疼痛程度之间的关系。方法:选取郑州大学第一附属医院2022年11月至2023年11月就诊的急性HZ及带状疱疹后神经痛(PHN)患者共60例进行病例对照研究,其中HZ组25例,PHN组35例,分别于入院当天测量病变区域的压力疼痛阈值,同时评估两组患者的视觉模拟评分法(VAS)评分;并腰椎穿刺收取脑脊液2 mL,用酶联免疫吸附法检测患者脑脊液中相关趋化因子含量。结果:HZ组趋化因子CXCL1、CXCL10分别为(24.84±6.97)ng/L、(107.46±28.29)μg/L,PHN组分别为(20.51±3.16)ng/L、(132.98±30.92)μg/L,两组差异均有统计学意义(t=2.91、-3.26,均P<0.05);两组趋化因子CCL2、CX3CL1水平差异均无统计学意义(t=1.62、-0.23,均P>0.05)。两组CCL2、CXCL1、CX3CL1、CXCL10水平均与压力疼痛阈值呈负相关(HZ组:r=-0.84、-0.78、-0.93、-0.86,PHN组:r=-0.71、-0.78、-0.94、-0.76,均P<0.01)。结论:急慢性HZ患者脑脊液中较高的趋化因子水平会使患者的神经痛更加明显,趋化因子参与的神经免疫炎症可能与急慢性HZ的神经痛疼痛程度有一定相关性。Objective To investigate the levels of chemokine 2(CCL2),chemokine(C-X-C motif)ligand 1(CXCL1),chemokine(C-X3-C motif)ligand 1(CX3CL1),and chemokine(C-X-C motif)ligand 10(CXCL10)in the cerebrospinal fluid of patients with acute and chronic herpes zoster(HZ),and their correlation with the severity of neuropathic pain.Methods A total of 60 patients with acute herpes zoster and postherpetic neuralgia(PHN)treated at the First Affiliated Hospital of Zhengzhou University from November 2022 to November 2023 were selected for a case-control study.These patients were divided into a HZ group(n=25)and a PHN group(n=35).The pressure pain threshold in the affected area was measured on the day of admission for all patients.The Visual Analogue Scale scores were evaluated in both groups.After lumbar puncture,2 mL of cerebrospinal fluid was collected,and the levels of related chemokines in the cerebrospinal fluid were detected using the enzyme-linked immunosorbent assay.Results In the HZ group,the levels of chemokines CXCL1 and CXCL10 were(24.84±6.97)ng/L and(107.46±28.29)μg/L,respectively,while in the PHN group,they were(20.51±3.16)ng/L and(132.98±30.92)μg/L.The differences in the levels of chemokines CXCL1 and CXCL10 between the two groups were statistically significant(t=2.91,-3.26,both P<0.05).There were no statistically significant differences in the levels of chemokines CCL2 and CX3CL1 between the two groups(t=1.62,-0.23,both P>0.05).The levels of CCL2,CXCL1,CX3CL1,and CXCL10 in both groups were negatively correlated with the pressure pain threshold(HZ group:r=-0.84,-0.78,-0.93,-0.86;PHN group:r=-0.71,-0.78,-0.94,-0.76,all P<0.01).Conclusion Higher levels of chemokines in the cerebrospinal fluid of patients with acute and chronic HZ are associated with more pronounced neuropathic pain.The neuro-immune inflammation involving chemokines may be correlated with the severity of neuropathic pain in acute and chronic HZ.

关 键 词：带状疱疹 神经痛 带状疱疹后 趋化因子类 脑脊髓液 疼痛测定 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]