带状疱疹患者皮肤温度觉阈值变化及意义的临床研究

Clinical study on the changes and significance of thermal sensation thresh-olds in patients with herpes zoster

目的对带状疱疹患者患侧及健侧皮肤的温度觉阈值进行测定和定量分析,以了解其小神经纤维功能状态。方法选择2015年12月~2017年2月重庆医科大学附属第一医院疼痛科就诊的带状疱疹患者80例作为研究对象,使用TSA-Ⅱ型温度感觉分析仪,采用界限法测定其患侧及健侧皮肤的冷觉(CS)、温觉(WS)、冷痛觉(CP)及热痛觉(HP)阈值,并进行统计学分析。Pearson相关分析法分析带状疱疹患侧皮肤温度觉阈值与病程、数字评价量表(NRS)、ID pain评分的相关性。结果带状疱疹患者患侧皮肤CS、CP阈值低于健侧,HP阈值高于健侧,差异均有统计学意义(均P<0.05);两侧皮肤WS阈值比较,差异无统计学意义(P>0.05)。带状疱疹患者患侧皮肤CS、CP阈值与病程呈负相关(r=-0.399、-0.374,P<0.05)。结论温度觉阈值检查是评估C类和Aδ类小纤维神经功能障碍的一种客观的方法,有利于带状疱疹患者感觉神经损伤的诊断和严重程度的评估。

Objective To measure and quantitative analyze the thermal sensation thresholds of the affected side and healthy side skin of herpes zoster patients,in order to understand the function of primary afferent fibers in the patients with herpes zoster.Methods From December 2015 to February 2017,80 cases with herpes zoster who admitted to Department of Pain,the First Affiliated Hospital of Chongqing Medical University as research objects.TSA-Ⅱthermal sensation analyzer was used to detect the cold sensation(CS),warm sensation(WS),cold pain sensation(CP)and heat pain sensation(HP)thresholds by using the method of limits.Statistical analysis was performed and Pearson correlation analysis was used to analyze the correlation between the thermal sensation thresholds of the affected sides of herpes zoster patients and the course of disease,numerical rating scale(NRS),ID pain scores.Results The CS and CP thresholds on the affected side were lower than those on the healthy side,and the HP thresholds were higher than those on the healthy side,and the differences were statistically significant(all P<0.05).There was no significant difference in the WS thresholds between the two sides(P>0.05).The CS and CP thresholds of the affected side were negatively correlated with the course of disease(r=-0.399,-0.374,P<0.05).Conclusion The thermal sensation thresholds testing is one of the objective methods to evaluate the function of C and Aδprimary afferent fibers,which is beneficial to diagnose and evaluate the severity of peripheral nerve damage of the disease.