【罂粟摘要】炎症标志物在预测急性带状疱疹患者带状疱疹后神经痛中的作用

炎症标志物在预测急性带状疱疹患者带状疱疹后神经痛中的作用

贵州医科大学    麻醉与心脏电生理课题组

翻译：刘云琴 编辑：潘志军  审校：曹莹

背景: 越来越多的证据表明，对水痘-带状疱疹病毒复制做出反应的神经元炎症在带状疱疹后神经痛(PHN)的发展中起关键作用。

目的：在本研究中，我们研究了急性带状疱疹（HZ）患者血清中各种炎症标志物水平作为PHN发生的预测因子的价值。

方法: 本研究共纳入116例急性期HZ患者。我们在基线检查时以及诊断HZ后1个月、3个月和6个月时测量疼痛视觉模拟量表（VAS）评分。我们将PHN定义为VAS评分大于1分且持续6个月以上。在初次访视时采集了用于实验室检测的血清样本，包括全血细胞计数。评估各炎症标志物水平与PHN发生的相关性。

结果:单因素分析显示，红细胞沉降率（ESR）、C反应蛋白（CRP）、淋巴细胞计数和白蛋白水平与PHN的发生显著相关。在多因素分析中，ESR、CRP和淋巴细胞计数水平也存在显著的相关性。ESR水平与PHN发生的相关性高于CRP水平和淋巴细胞计数。

结论:在这项研究中，我们证实ESR升高是急性HZ患者PHN的独立和显著的预测因素。为了验证这些结果，需要进一步设计良好的随机临床试验。

原始文献来源：

Kim JY, Park GH, Kim MJ, et al. Usefulness of Inflammatory Markers for the Prediction of Postherpetic Neuralgia in Patients with Acute Herpes Zoster. Ann Dermatol. 2018;30(2):158-163.

  英文原文

Usefulness of Inflammatory Markers for the Prediction of Postherpetic Neuralgia in Patients with Acute Herpes Zoster

Background: Increasing evidence suggests a pivotal role for neuronal inflammation in response to replicating varicella zoster virus in the development of postherpetic neuralgia (PHN).

Objective: In this study, we investigated the value of serum levels of various inflammatory markers in acute her-pes zoster (HZ) as predictors for the development of PHN.

Methods: A total of 116 patients with acute HZ were enrolled in this study. We measured scores on the pain visual ana-logue scale (VAS) at baseline and at 1, 3, and 6 months after diagnosis of HZ. We defined PHN as pain greater than 1 on the VAS lasting for more than 6 months. Serum samples for laboratory assay, including complete blood count were ob-tained at the initial visit. Correlations between the levels of each inflammatory  marker and the development of PHN were evaluated.

Results: Levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte count, and albumin showed significant correlations with development of PHN in univariate analysis. Levels of ESR, CRP, and lym-phocyte count also showed significant correlations in multi-variate analysis. ESR level showed stronger correlations with development of PHN than levels  of CRP and lymphocyte count.

Conclusion: In this study, we confirmed that elevated ESR was an independent and significant predictor of PHN in patients with acute HZ. To  validate these results, further well-designed, randomized clinical trials are needed.

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