标题：血清Leptin、MCP-1预测急性带状疱疹患者后遗神经痛的临床价值

      作者：韩玲玲 1，荣淑宁 2，王磊 1    1.安阳市人民医院疼痛科，河南 安阳 455000；2.安阳职业技术学院，河南 安阳 455000

      卷次： 2023年34卷23期

      【摘要】 目的 探讨血清瘦素(Leptin)、单核细胞趋化蛋白-1 (MCP-1)水平预测急性带状疱疹患者发生后遗神经痛(PHN)的临床价值。方法 前瞻性选择2020年1月至2022年1月经安阳市人民医院确诊的168例急性带状疱疹患者作为研究对象，治疗后随访3个月，根据是否出现PHN分为PHN组78例，无PHN组90例。同时选择同期在我院体检的96例健康人作为健康组。检测并比较所有受检者的血清Leptin、MCP-1水平；采用Pearson相关法分析血清Leptin、MCP-1与数字评分法(NRS)评分的相关性，采用受试者工作特征曲线(ROC)及曲线下面积(AUC)评估血清Leptin、MCP-1水平对急性带状疱疹患者发生PHN的预测价值，同时采用多因素Logistic回归分析探究影响急性带状疱疹患者发生PHN的危险因素。结果 PHN组患者的血清Leptin、MCP-1水平明显低于无PHN组和健康组，无PHN组明显低于健康组，差异均有统计学意义(P<0.05)；经Pearson相关分析结果显示，急性带状疱疹患者血清Leptin、MCP-1与NRS评分均呈负相关(r=-0.406、-0.452，P<0.001)；经ROC分析结果显示，血清Leptin预测急性带状疱疹患者发生PHN的AUC为0.769，截断值为16.8 μg/L，敏感度、特异度分别为92.31%、50.00%；血清MCP-1预测急性带状疱疹患者发生PHN的AUC为0.832，截断值为101.4 pg/μL，敏感度、特异度分别为92.31%、67.78%；血清Leptin联合MCP-1预测急性带状疱疹患者发生PHN的AUC为0.921，敏感度、特异度分别为85.90%、85.56%；经多因素Logistic回归分析结果显示，血清Leptin、MCP-1、NRS评分均为影响急性带状疱疹患者发生PHN的危险因素(P<0.05)。结论 急性带状疱疹患者血清Leptin、MCP-1水平均降低，且与NRS评分均呈负相关，有望作为预测急性带状疱疹患者发生PHN的有效生物学标志物。
      【关键词】 急性带状疱疹；后遗神经痛；瘦素；单核细胞趋化蛋白-1；预测价值
      【中图分类号】 R752.1+2 【文献标识码】 A 【文章编号】 1003—6350（2023）23—3392—05

Clinical value of serum Leptin and monocyte chemoattractant protein-1 in predicting postherpetic neuralgia inpatients with acute herpes zoster.
HAN Ling-ling 1, RONG Shu-ning 2, WANG Lei 1. 1.Department of Pain, AnyangPeople's Hospital, Anyang 455000, Henan, CHINA; 2. Anyang Vocational and Technical College, Anyang 455000, Henan,CHINA
【Abstract】 Objective To analyze the clinical value of serum leptin (Leptin) and monocyte chemoattractant pro-tein-1 (MCP-1) levels in predicting postherpetic neuralgia (PHN) in patients with acute herpes zoster. Methods A totalof 168 patients with acute herpes zoster diagnosed in Anyang People's Hospital from January 2020 to January 2022 wereprospectively chosen as the research subjects. The patients were followed up for 3 months after treatment, and they weredivided into PHN group (78 cases) and non-PHN group (90 cases) according to whether PHN occurred. At the sametime, 96 health examinees from the hospital during the same time period were selected as the health group. Serum Leptinand MCP-1 levels of all subjects were detected and compared. Pearson correlation analysis was used to analyze the cor-relation between serum Leptin, MCP-1 and numerical rating scale (NRS) score. Receiver operating characteristic curve(ROC) and area under the curve (AUC) were used to evaluate the predictive value of serum Leptin and MCP-1 levels forPHN in patients with acute herpes zoster. Multivariate logistic regression analysis was used to explore the risk factors forPHN in patients with acute herpes zoster. Results Serum Leptin and MCP-1 levels in the PHN group were significant-ly lower than those in the non-PHN group and healthy group, while those in the non-PHN group were significantly lowerthan those in the healthy group, with statistically significant differences (P<0.05). Pearson correlation analysis showedthat serum Leptin, MCP-1 were negatively correlated with NRS scores in patients with acute herpes zoster (r=-0.406, P<0.001; r=-0.452, P<0.001). The results of ROC curve analysis showed that AUC of serum Leptin for predicting PHN inpatients with acute herpes zoster was 0.769, and the cut-off value was 16.8 μ g/L, with the sensitivity, specificity of92.31%, 50.00%. The AUC of PHN in patients with herpes zoster was 0.832, and the cut-off value was 101.4 pg/μL,with the sensitivity and specificity of 92.31% and 67.78% , respectively. The AUC of serum Leptin combined withMCP-1 for predicting PHN in patients with acute herpes zoster was 0.921, and the specificity, sensitivity were 85.56%,85.90%. Multivariate Logistic regression analysis showed that serum Leptin, MCP-1, and NRS scores were risk factorsfor PHN in patients with acute herpes zoster (P<0.05). Conclusion Serum levels of Leptin and MCP-1 are decreasedin patients with acute herpes zoster, and both are negatively correlated with NRS score, which are expected to be effec-tive biomarkers for predicting PHN in patients with acute herpes zoster.
      【Key words】 Acute herpes zoster; Postherpetic neuralgia; Leptin; Monocyte chemoattractant protein-1; Predic-tive value