疱疹后遗神经痛病人的神经损伤与水痘-带状疱疹病毒持续激活和复制的关系

Persistent activation and duplication of Varicella-Zoster virus in patients with postherpes neuralgia.

目的 研究带状疱疹后遗神经痛 (PHN)患者的水痘 带状疱疹病毒 (VZV)持续激活、复制对感觉神经系统损伤的影响。方法 用感觉定量分析仪 (TSA 2 0 0 1)对 2 5例PHN患者和 38例带状疱疹患者的疼痛区及对侧镜像区进行感觉定量测量 ,同时用PCR和SouthernBlot方法对其外周血单核细胞 (PBMC)进行VZV检测。结果 带状疱疹急性期和PHN病人疼痛区的各感觉阈值均大于对侧镜像区 ,而愈后无PHN的带状疱疹病人两者间未见显著性差异 ;PHN病人的感觉缺失值大于带状疱疹急性期病人 ;PHN患者的VZV检出率为 32 % ,而在愈后无PHN患者却未检测到。结论 VZV在带状疱疹患者的背根神经节内长久复制和激活会引起神经系统严重的、甚至是不可逆的损伤 。

Objective To examine the effect of the persistent reactivation and duplication of VZV on the injury of the nerve system in patients with postherpetic neuralgia(PHN). Methods The quantitative sensory test(QST) by the Thermal Sensory Analyzer (TSA-2001) was performed at both painful skins and contralaeral mirror-image areas in 25 patients with PHN and 38 patients with herpes zoster,and Nested PCR and Southern blot were used to identify viral infection of peripheral blood mononuclear cells(PBMCs). Results The sensory thresholds in rash/pain areas were higher than mirror-image areas in the patients with either acute zoster or PHN,while they were almost the same in those without neuralgia. Patients with PHN presented more serious thermal sensory deficits than those in acute period. VZV(varicella zoster virus)was detected in the blood samples of 32%patients with PHN,but in none of patients without postherpes neuralgia. Conclusions The persistent reactivation and duplication of VZV in the basal ganglion of spinal cord in patients with herpes zoster may cause severe unreversible damage of nervous system, which may result in PHN.