血清miR-21、缺氧诱导因子-1α水平在带状疱疹患者治疗前后变化及评估后遗神经痛的分析

Changes of serum miR-21 and HIF-1α levels before and after treatment in patients with herpes zoster and ROC analysis for evaluating postherpetic neuralgia

目的 探讨血清miR-21、缺氧诱导因子-1α(HIF-1α)水平在带状疱疹患者治疗前后变化及对发生后遗神经痛的评估价值。方法 选取2019年6月至2022年4月我院带状疱疹患者183例,其中122例作为训练组创建模型,另61例作为验证组评判模型,同时选取健康体检者61例作为对照组。带状疱疹患者均常规治疗。三组均检测血清miR-21、HIF-1α水平。分析训练组发生后遗神经痛的相关因素及血清miR-21、HIF-1α水平对发生后遗神经痛的评估价值。结果 训练组治疗前、治疗1周血清miR-21、HIF-1α水平高于对照组(P <0.05),训练组治疗1周血清miR-21、HIF-1α水平低于同组治疗前(P <0.05);血清miR-21、HIF-1α水平仍为带状疱疹患者发生后遗神经痛的独立影响因素(P <0.05);Logistic回归模型在训练组评估发生后遗神经痛的AUC为0.876,验证组中评估发生后遗神经痛的AUC为0.869。结论 血清miR-21、HIF-1α在带状疱疹患者中呈高表达,经治疗后其水平明显下降,且miR-21、HIF-1α水平升高为患者发生后遗神经痛的独立危险因素,基于二者水平构建的风险模型具有较高的评估效能。

Objective To investigate the changes of serum micrornA-21(miR-21)and hypoxia-induced-factor-1α(HIF-1α)levels before and after treatment in patients with herpes zoster and their evaluation value for postharcoma neuralgia.Methods From June 2019 to April 2022,183 patients with herpes zoster in our hospital were selected,of which 122 were chosen as training group to establish the model,and another 61 as validation group to verify the model.At the same time,61 healthy subjects were selected as control group.All patients with herpes zoster were treated with conventional regimens.Serum miR-21 and HIF-1αlevels were detected in all the three groups.Related factors of posthumous neuralgia in the training group and the value of serum miR-21 and HIF-1αlevels in the evaluation of postharcoma neuralgia was analyzed.Results The levels of serum miR-21 and HIF-1αin the training group before treatment and one week after treatment were higher than those in the control group(P<0.05),and the levels of serum miR-21 and HIF-1αin the training group after one week of treatment was lower than those in the same group before treatment(P<0.05).Serum miR-21 and HIF-1αlevels were still independent influencing factors for postherpetic neuralgia in patients with herpes zoster(P<0.05).The AUC of the logistic regression model in the training group was 0.876.In the validation group,that was 0.869.Conclusion Serum miR-21 and HIF-1αexpress highly in patients with herpes zoster,and their levels significantly decrease after treatment.Elevated levels of miR-21 and HIF-1αare independent risk factors for postherpetic neuralgia in patients.The risk model constructed based on serum miR-21 and HIF-1αlevel has high evaluation efficiency.