带状疱疹患者血清中ESR、CRP、IL-1、免疫球蛋白与后遗神经痛的关系

Relationship between ESR,CRP,IL-1,immunoglobulin and afterneuralgia in patients with herpes zoster

目的探讨带状疱疹患者血清中红细胞沉降率(ESR)、C反应蛋白(CRP)、白介素-1(IL-1)及免疫球蛋白与后遗神经痛(PHN)的关系。方法选取2017年11月至2021年5在西安交通大学医学院附属三二〇一医院康复医学科接受治疗的82例带状疱疹患者,对其随访3个月,根据其是否发生PHN,分为后PHN组(52例),未发生PHN组(30例)。对比两组患者首次入院时炎性指标白介素-1(IL-1)、白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF)、CRP及ESR水平;比较两组血清免疫球蛋白IgA、IgM、IgG、C4、C3水平;利用受试者工作特征(ROC)曲线分析ESR、CRP、IL-1等炎性指标及免疫球蛋白对PHN的预测价值。结果PHN组患者血清IL-1、IL-10、IL-6、TNF-α、CRP及ESR显著高于未发生PHN组,差异有统计学意义(P<0.05);PHN组患者血清免疫球蛋白IgA、IgM、IgG、C4、C3水平均显著低于未发生PHN组,差异有统计学意义(P<0.05);ROC曲线分析结果显示IL-6,IL-1,CRP,TNF-α,ESR,IgA,C3,C4,IgG,IgM对PHN有较高的诊断价值(P<0.05)。结论带状疱疹患者血清ESR、CRP、IL-1及免疫球蛋白可间接或直接反应机体炎性程度,对PHN具有较好预测价值。

Objective To investigate the relationship between serum erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),interleukin-1(IL-1),immunoglobulin and postherpetic neuralgia(PHN)in patients with herpes zoster.Methods 82 patients with herpes zoster treated in the Department of rehabilitation medicine,3201 Hospital Affiliated to the Medical College of Xi’an Jiaotong University from November 2017 to may 2021 were followed up for 3 months.According to whether they developed PHN,PHN group(52 cases)and non PHN group(30 cases).The inflammatory indexes such as IL-1,interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-A(TNF),CRP and ESR were compared between the two groups;The levels of serum immunoglobulin IgA,IgM,IgG,C4 and C3 were compared between the two groups;The receiver operating characteristic(ROC)curve was used to analyze the inflammatory indexes such as ESR,CRP and IL-1 and the predictive value of immunoglobulin on PHN.Results Serum IL-1,IL-10,IL-6,TNF-α,CRP and ESR in PHN group were significantly higher than those in non PHN group(P<0.05);The levels of serum immunoglobulin IgA,IgM,IgG,C4 and C3 in PHN group were significantly lower than those in non PHN group(P<0.05);ROC curve was used to analyze the predictive value of serum inflammatory indexes and immunoglobulin for PHN in herpes zoster.The results showed that 10 items of IL-6,IL-1,CRP,TNF-α,ESR,IgA,C3,C4,IgG and IgM would have high diagnostic value for PHN.Conclusion Serum ESR,CRP,IL-1 and immunoglobulin in patients with herpes zoster can indirectly or directly reflect the degree of inflammation,and have good predictive value for PHN.