机构地区:[1]资阳市中心医院神经外科,四川资阳641300 [2]三台县人民医院神经外科,四川绵阳621100 [3]重庆市铜梁区人民医院神经外科,重庆402560
出 处:《国际检验医学杂志》2025年第9期1041-1045,1050,共6页International Journal of Laboratory Medicine
基 金:四川省卫生健康委员会科技项目(23LCYJ006)。
摘 要:目的探讨血清血管活性肠肽(VIP)、5-羟色胺(5-HT)水平变化对带状疱疹后神经痛(PHN)患者脊髓电刺激(SCS)疾病转归的预测价值。方法选取2022年1月至2023年12月在资阳市中心医院接受SCS治疗的96例PHN患者,根据所有PHN患者治疗6个月后的疾病转归分为良好组(n=71)与不良组(n=25)。收集两组临床资料并检测所有患者治疗前的血清VIP、5-HT水平。采用受试者工作特征(ROC)曲线评估血清VIP、5-HT对PHN患者SCS治疗后疾病转归的预测价值,采用多因素Logistic回归分析探讨PHN患者SCS治疗疾病转归的影响因素。结果不良组患者血清VIP、5-HT水平均高于良好组(P<0.05)。血清VIP、5-HT预测PHN患者SCS治疗后疾病转归的曲线下面积(AUC)分别为0.829(95%CI:0.779~0.874)、0.743(95%CI:0.693~0.793),两者联合预测的AUC为0.941(95%CI:0.891~0.986)。两组患者年龄、性别、体重指数、学历、发病部位、高血压、饮酒史比较,差异无统计学意义(P>0.05);不良组初治入院时间长于良好组,皮疹面积大于良好组,糖尿病、吸烟史占比高于良好组(P<0.05)。初治入院时间>3 d(OR=2.188,95%CI:1.383~3.461),皮疹面积>10 cm^(2)(OR=2.018,95%CI:1.283~3.173),糖尿病(OR=2.264,95%CI:1.379~3.717),血清VIP水平≥41.78 ng/L(OR=3.022,95%CI:1.685~5.420),血清5-HT水平≥99.27ng/m L(OR=3.579,95%CI:1.885~6.793)是PHN患者SCS治疗后疾病转归的影响因素(P<0.05)。结论治疗前血清VIP、5-HT水平上升与带状疱疹后神经痛患者脊髓电刺激后转归不良有关,可作为预测带状疱疹后神经痛患者脊髓电刺激疾病转归的潜在标志物。Objective To investigate the predictive value of serum vasoactive intestinal peptide(VIP)and 5-hydroxytryptamine(5-HT)levels on the outcome of spinal cord electrical stimulation(SCS)in patients with postherpetic neuralgia(PHN).Methods A total of 96 PHN patients who received SCS treatment in Ziyang Central Hospital from January 2022 to December 2023 were selected.According to the disease outcomes of all PHN patients after 6 months of treatment,a good group(n=71)and a poor group(n=25)were set up.The clinical data of the two groups were collected and the serum VIP and 5-HT levels were detected in all patients before treatment.The predictive value of serum VIP and 5-HT on disease outcome after SCS treatment in PHN patients was evaluated by receiver operating characteristic(ROC)curve,and the influencing factors of disease outcome after SCS treatment in PHN patients was explored by multivariate Logistic steppe gression analysis.Results The levels of serum VIP and 5-HT in poor group were higher than those in good group(P<0.05).The area under the curve(AUC)of serum VIP and 5-HT for predicting the disease outcome of PHN patients after SCS treatment were 0.829(95%CI:0.779-0.874)and 0.743(95%CI:0.693-0.793),respectively,and the AUC of combined prediction was 0.941(0.891-0.986).There were no significant differences in age,gender,body moss index,education,location of onset,hypertension and drinking history between the two groups(P>0.05).The time of initial hospital admission in the poor group was longer than that in the good group,skin rash area in the poor group was larger than that in the good group,and diabetes mellitus and smoking history in the poor group were higher than those in the good group(P<0.05).The time of admission for initial treatment>3 d(OR=2.188,95%CI:1.383-3.461),skin rash area>10 cm~2(OR=2.018,95%CI:1.283-3.173),diabetes mellitus(OR=2.264,95%CI:1.379-3.717),serum VIP level≥41.78 ng/L(OR=3.022,95%CI:1.685-5.420),serum 5-HT level≥99.27 ng/m L(OR=3.579,95%CI:1.885-6.793)were the influencing factors of di
关 键 词:带状疱疹后神经痛 脊髓电刺激 血管活性肠肽 5-羟色胺 预测价值
分 类 号:R752.12[医药卫生—皮肤病学与性病学]
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