急性期老年带状疱疹患者血清白细胞介素-1在预测发生后遗神经痛的临床效能

Clinical Efficacy of Serum Interleukin-1 in Predicting Postherpetic Neuralgia in Elderly Patients with Acute Herpes Zoster

目的探讨急性期老年带状疱疹(Herpes zoster,HZ)患者血清白细胞介素(IL)与后遗神经痛(PHN)的相关性。方法纳入我院212例急性期老年HZ患者作为研究对象,将42例发生PHN患者设为HZ-PHN组,其余170例设为HZ组,另选取35例健康者作为对照组。采用酶联免疫吸附测定(ELISA)法检测并比较3组研究对象血清IL-1水平的差异,通过Pearson相关分析血清IL-1水平与急性期老年HZ患者疼痛视觉模拟评分法(VAS)评分的相关性。急性期老年HZ患者发生PHN的影响因素采用Logistic分析。血清IL-1水平在预测急性期老年HZ患者发生PHN的临床效能采用受试者操作特征(ROC)曲线分析。结果HZ-PHN组患者血清IL-1水平同组相比显著升高(P=0.000);HZ组患者血清IL-1水平同对照组相比显著升高(P=0.000)。急性期老年HZ患者血清IL-1水平与VAS评分呈显著正相关性(r=0.598,P=0.000)。HZ分型(OR=10.444)、VAS评分(OR=6.501)和IL-1β(OP=4.369)均是急性期老年HZ患者发生PHN的危险因素。血清IL-1水平在预测急性期老年HZ患者发生PHN的临床效能显著,曲线下面积(AUC)为0.859,当截断值为23.25 pg/mL,此时敏感度为91.43%,特异度为88.37%,Youden指数为0.798。结论急性期老年HZ患者血清IL-1水平显著降低,IL-1可作为预测老年HZ患者发生PHN的一项生物学指标。

Objective In order to investigate the association between interleukin(IL)-1 and postherpetic neuralgia(PHN)in elderly patients with acute herpes zoster.Methods A total of 212 elderly patients with acute HZ in our hospital were included and 42 patients with PHN were divided into HZ-PHN group,the remaining 170 patients were divided into HZ group.The 35 healthy individuals were selected as the control group.The serum IL-1 levels among the three groups were detected by enzyme-linked immuno sorbent assay(ELISA)method and compared.The serum IL-1 levels and visual analogue scale(VAS)scores in elderly patients with acute HZ were analyzed by Pearson method.The influencing factors of PHN in elderly patients with acute HZ were analyzed by Logistic.The clinical efficacy of serum IL-1 in predicting PHN in elderly patients with acute HZ was analyzed by receiver operating characteristic(ROC)curve.Results The serum IL-1 levels in HZ-PHN group was significantly higher than HZ group(P=0.000),and the serum IL-1 levels in HZ group was significantly higher than control group(P=0.000).There was a significant positive correlation between serum IL-1 levels and VAS score in elderly patients with acute HZ(r=0.598,P=0.000).HZ clinical type(OR=10.444),VAS scores(OR=6.501)and IL-1β(OP=4.369)were the risk factors for PHN in elderly patients with acute HZ.The clinical efficacy of serum IL-1 levels in predicting PHN in elderly patients with acute HZ was significant(AUC=0.859).The cut-off value was 23.25 pg/mL.The sensitivity,specificity and Youden index were 91.43%,88.37%and 0.798,respectively.Conclusion The serum IL-1 levels is significantly decreased in elderly patients with acute HZ.IL-1 could be used as a biological index to predict the risk of PHN in elderly patients with HZ.