急性期带状疱疹患者Th17/Treg细胞与后遗神经痛的相关性

Correlation between Th17 / Treg cells and postoperative neuralgia in patients with acute herpes zoster

摘要:

目的：探讨急性期带状疱疹患者Th17/Treg细胞比值与后遗神经痛(Postherpetic neuralgia,PHN)疼痛程度的相关性,分析影响PHN的风险因素。方法：纳入我院在2016年7月至2020年1月收治的带状疱疹患者133例,检测患者急性期Th17细胞和Treg细胞水平,计算Th17/Treg比值,根据治疗后3个月是否发生PHN分为PHN组和非PHN组,比较两组患者临床资料,多因素logistic回归方程分析影响PHN的危险因素；分析急性期Th17/Treg比值与PHN的相关性。结果：130例患者中共发生PHN59例,占45.38%；单因素分析两组临床资料显示,PHN组年龄、发病至就诊时间、皮肤受累面积、Treg比例均高于非PHN组,Th17比例、Th17/Treg比值低于非PHN组,差异具有统计学意义(P<0.05)；Logistic回归显示,年龄越大(OR=1.158)、皮肤受累面积越大(OR=6.434)是影响PHN发生的危险因素,Th17/Treg比值(OR=0.916)是影响PHN发生的保护性因素(P<0.05)；Pearson相关性分析显示,急性期Th17/Treg比值与PHN疼痛程度呈负相关(r=-0.482,P=0.000)。结论：急性期带状疱疹Th17/Treg细胞比例失衡,可能会对后期PHN的发生及其疼痛严重程度产生一定影响。

Abstract:

Objective: To investigate the correlation between Th17 / Treg cell ratio and postherpetic neuralgia (PHN) pain in patients with acute herpes zoster, and to analyze the risk factors affecting PHN. Methods: A total of 133 patients with shingles treated in our hospital from July 2016 to January 2020 were enrolled, and the levels of Th17 cells and Treg cells in the acute phase of the patients were measured to calculate the Th17 / Treg ratio; According to whether PHN occurred 3 months after treatment, it was divided into PHN group and non-PHN group. The clinical data of the two groups were compared. Multivariate logistic regression equation was used to analyze the risk factors affecting PHN. The correlation between Th17 / Treg ratio and PHN in the acute phase was analyzed. Results: 59 cases of PHN occurred in 130 patients, accounting for 45.38%; Univariate analysis of the clinical data of the two groups showed that the age, onset of treatment, skin involvement area, and Treg ratio in the PHN group were higher than those in the non-PHN group(P<0.05); Logistic regression showed that older age (OR=1.158) and larger skin affected area (OR= 6.434) were risk factors affecting PHN occurrence, and Th17 / Treg ratio (OR= 0.916) was a protective factor affecting PHN occurrence (P<0.05); Pearson correlation analysis showed that the Th17/Treg ratio in the acute phase was negatively correlated with the degree of pain in PHN (r=-0.482,P=0.000). Conclusion: The imbalance of Th17/Treg cells in herpes zoster in the acute phase may have a certain effect on the occurrence of PHN and the severity of pain.