急性期带状疱疹疼痛患者血清水痘-带状疱疹病毒DNA检测及其意义

Detection and significance of serum varicella-zoster virus DNA in patients with acute herpes zoster neuralgia

目的探讨水痘-带状疱疹病毒(VZV)DNA载量在急性期带状疱疹疼痛中的临床意义,为治疗带状疱疹(herpes zoster,HZ)以及预测带状疱疹后神经痛(herpes zoster neuralgia,PHN)提供依据。方法收集急性期带状疱疹疼痛患者50例,所有患者分别在入院、出院时进行VAS疼痛评分以及测定VZV DNA载量,于出院3月后随访是否发生PHN。结果急性期HZ疼痛患者治疗前VZV检测出19例,阳性率为38%,治疗后VZV检测出6例,阳性率为12%,治疗后VAS评分、VZV DNA载量较治疗前明显降低,两者相比,P<0.05。发生PHN者治疗前VAS评分较未发生PHN者高,两者相比,P<0.05。VZV DNA载量二者无差异(P﹥0.05)。治疗后发生PHN者VZV DNA载量较未发生PHN者高,两者相比,P<0.05。结论急性期带状疱疹患者VZV DNA载量越高,疼痛程度越重,更易发生PHN,VZV DNA检测对指导HZ的治疗和预测PHN的发生具有一定价值。

Objective To investigate the clinical significance of the varicella-zoster virus（ VZV） DNA load in herpes zoster（ HZ） neuralgia,which provides theoretical basis for better clinical treatment of HZ and prediction of the occurrence of herpes zoster neuralgia（ PHN）. Methods Fifty patients with HZN were selected,and their visual analogue scale（ VAS） and VZV DNA load were recorded on admission and discharge. All patients were followed up on occurrence of PHN at 3 month after discharge. Results Ninety cases of 50 HZ patients were detected VZV before treatment,and the positive rate was 38%; 6 cases of 50 HZ patients were detected VZV after treatment,and the positive rate was 12%. After treatment,VAS score and VZV DNA load were significantly lower than those before treatment,and the difference was statistically significant（ P〈0. 05）. The VAS score of PHN patients was significantly higher than that of non-PHN patients（ P〈0. 05）,and no significant difference was found in the VZV DNA load between PHN patients and non-PHN patients（ P〉0. 05）. The VZV DNA load of PHN patients was significantly higher than that of non-PHN patients after treatment（ P〈0. 05）. Conclusions The higher the VZV DNA load of HZ patients in the acute phase,the more severe the pain and the more prone to PHN. VZV DNA detection is of value in guiding the treatment of HZ and predicting the occurrence of PHN.