Zhao Chengcheng, Lu Ziwei, Hua Bohan, Yue Jiayu, Yang Qinru, Ni Huadong, Yao Ming
Jiaxing University Master's Degree Cultivation Base, Zhejiang Chinese Medical University, Jiaxing City, Zhejiang Province, People's Republic of China.
Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, Jiaxing City, Zhejiang Province, People's Republic of China.
J Pain Res. 2024 Oct 2;17:3241-3253. doi: 10.2147/JPR.S472535. eCollection 2024.
This study aimed to evaluate the prognostic accuracy of the Current Perception Threshold (CPT) in Acute Herpetic Neuralgia (AHN) patients receiving Pulsed Radiofrequency (PRF) therapy and to develop a corresponding prognostic model.
We retrospectively analyzed data from 106 AHN patients treated with PRF between January 2022 and May 2023. The occurrence of Postherpetic Neuralgia (PHN) after treatment categorized patients into non-PHN and PHN groups. The predictive role of CPT indices for PRF outcomes was assessed using the Receiver Operating Characteristic (ROC) curve and Area Under Curve (AUC). Then the dataset was split into a training set (n=74) and a validation set (n=32). Factors associated with PHN development were identified using univariate and multivariate logistic regression. A nomogram model was developed using significant predictors and internal validation was performed using valid set data.
Among the 106 patients, 45 had a poor prognosis. Significant differences in age, preoperative Numerical Rating Scale (NRS) score, and 5Hz CPT ratio were observed between the groups (<0.05). Logistic regression identified these factors as independent predictors for PRF prognosis (<0.05). The 5Hz CPT ratio demonstrated predictive value (AUC= 0.764, 95% CI: 0.674-0.855). The nomogram model, incorporating these predictors, showed high AUC in both the training (0.863, 95% CI: 0.776-0.950) and validation sets (0.859, 95% CI: 0.721-0.998). Calibration curves indicated good model fit, and the Hosmer-Lemeshow test confirmed this (>0.05). Decision Curve Analysis (DCA) highlighted the model's predictive advantage.
The 5Hz CPT ratio can predict the prognosis of PRF in AHN patients. The nomogram model has high precision and clinical utility. It can help identify AHN patients with a poor PRF prognosis at an early stage and assist in clinical decision-making.
本研究旨在评估接受脉冲射频（PRF）治疗的急性疱疹性神经痛（AHN）患者中电流感觉阈值（CPT）的预后准确性，并建立相应的预后模型。
我们回顾性分析了2022年1月至2023年5月期间接受PRF治疗的106例AHN患者的数据。根据治疗后带状疱疹后神经痛（PHN）的发生情况将患者分为非PHN组和PHN组。使用受试者工作特征（ROC）曲线和曲线下面积（AUC）评估CPT指标对PRF治疗结果的预测作用。然后将数据集分为训练集（n = 74）和验证集（n = 32）。使用单因素和多因素逻辑回归确定与PHN发生相关的因素。使用显著预测因子建立列线图模型，并使用验证集数据进行内部验证。
106例患者中，45例预后较差。两组之间在年龄､术前数字评分量表（NRS）评分和5Hz CPT比值方面存在显著差异（<0.05）。逻辑回归确定这些因素为PRF预后的独立预测因子（<0.05）。5Hz CPT比值显示出预测价值（AUC = 0.764，95% CI：0.674 - 0.855）。纳入这些预测因子的列线图模型在训练集（0.863，95% CI：0.776 - 0.950）和验证集（0.859，95% CI：0.721 - 0.998）中均显示出较高的AUC。校准曲线表明模型拟合良好，Hosmer-Lemeshow检验证实了这一点（>0.05）。决策曲线分析（DCA）突出了该模型的预测优势。
5Hz CPT比值可预测AHN患者PRF的预后。列线图模型具有较高的精度和临床实用性。它可以帮助早期识别PRF预后较差的AHN患者，并协助临床决策。
