摘要
目的探讨脊髓电刺激(Spinal cord stimulation,SCS)治疗带状疱疹后神经痛(Postherpetic neuralgia,PHN)患者血清β-内啡肽(β-endorplhin,β-EP)、神经降压素(Neurotensin,NT)水平变化及对治疗反应性的评估价值。方法选取2021年7月-2023年3月武汉市新洲区人民医院接受SCS治疗的PHN患者108例作为研究组,根据治疗6个月效果分为反应良好患者、反应差患者。根据随机病例对照研究原则1∶1选取同期常规药物治疗的PHN患者108例作为对照组。检测并比较两组血清β-EP、NT水平及对治疗反应性的评估价值。结果治疗前,两组血清β-EP、NT水平比较,差异无统计学意义(P>0.05);治疗后,两组血清β-EP、NT水平较治疗前均升高,且研究组高于对照组(P<0.05)。皮疹面积≥10 cm^(2)、初治时间>3 d是PHN治疗反应差的独立危险因素,血清β-EP、NT水平升高是PHN治疗反应差的独立保护因素(P<0.05)。受试者工作特征(Receiver operating characteristic curve,ROC)分析显示,血清β-EP、NT水平单独预测PHN治疗反应差的曲线下面积(Area under curve,AUC)值分别为0.776、0.793,加入多因素Logistic回归模型后可将AUC值提升至0.936,高于血清β-EP(Z=3.490,P=0.001)、NT(Z=3.430,P=0.001)单独预测。结论SCS治疗可提升PHN患者血清β-EP、NT水平,二者联合检测可为临床评估SCS疗效提供参考。
Objective To investigate the changes of serumβ-endorphin(β-EP)and neurotensin(NT)levels in patients with postherpetic neuralgia(PHN)and evaluate the therapeutic responsiveness.Methods A total of 108 PHN patients who received SCS treatment in thehospital from July 2021 to March 2023 were selected as the study group.The patients were further divided into well-responding patients and poorly-responding patients based on their treatment outcomes after 6 months.Additionally,following the principle of 1:1 random case-control study,108 PHN patients who underwent conventional drug treatment during the same period were selected as control group.The serum levels ofβ-EP and NT were measured and compared in each group.Results Before the treatment,the serum levels ofβ-EP and NT in the 2 groups were not significantly different(P>0.05),but after the treatment,the serum levels ofβ-EP and NT in the study group were significantly higher than those in the control group(P<0.05).Skin rash area≥10 cm^(2) and initial treatment time>3d were independent risk factors for poor PHN response of SCS,and itelevated serum levels ofβ-EP and NT were independent protective factors for poor PHN response of SCS(P<0.05).ROC analysis showed that the AUC value of serumβ-EP and NT levels alone in predicting the poor PHN response of SCS treatment was 0.776 and 0.793,respectively,and the AUC value was increased to 0.936 after the addition of multivariate Logistic regression model,which was higher than that of serumβ-EP(Z=3.490,P=0.001)and NT(Z=3.430,P=0.001)levels predicted separately.Conclusion Serumβ-EP and NT levels in PHN patients are different before and after SCS treatment,and the serumβ-EP and NT levels after the treatment are related to the long-term efficacy of SCS,and the combined detection can provide a reference for clinical evaluation of the long-term efficacy of SCS.
作者
程瑾霞
张锐
程伟宁
黄荣
谭登云
CHENG Jinxia;ZHANG Rui;CHENG Weining;HUANG Rong;TAN Dengyun(Department of Neurology,Xinzhou District People′s Hospital,Wuhan 431400,China)
出处
《新疆医科大学学报》
CAS
2024年第4期548-552,558,共6页
Journal of Xinjiang Medical University
基金
湖北省卫生健康委员会科研课题项目(WJ2019M035)。
关键词
带状疱疹后神经痛
脊髓电刺激
β-内啡肽
神经降压素
postherpetic neuralgia
spinal cord electrical stimulation
beta-endorphins
neurotensin
