Wu Dan, Li Fang, Yang Feifei, Liu Jun
Department of Dermatology, Peking University First Hospital Ningxia Women and Children's Hospital (Ningxia Hui Autonomous Region Maternal and Child Health Hospital), Yinchuan City, Ningxia Hui Autonomous Region, 750011, People's Republic of China.
Department of Pathology, Peking University First Hospital Ningxia Women and Children's Hospital (Ningxia Hui Autonomous Region Maternal and Child Health Hospital), Yinchuan City, Ningxia Hui Autonomous Region, 750011, People's Republic of China.
Int J Gen Med. 2024 Oct 18;17:4805-4814. doi: 10.2147/IJGM.S480411. eCollection 2024.
Numerous lines of evidence suggest that neuropeptide Y (NPY) is critically involved in the modulation of neuropathic pain. Postherpetic neuralgia (PHN) is characterized by prolonged duration, severe pain, and significant treatment resistance, substantially impairing patients' quality of life. This study aims to evaluate the potential of plasma NPY levels in patients with PHN as a predictive biomarker for the development of this condition.
Between February 2022 and December 2023, 182 patients with herpes zoster (HZ) were recruited. Thirty-eight volunteers with no history of HZ were also recruited as controls. Clinical factors, NPY, brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) were assessed within 3 days of healing. Logistic regression analysis was used to predict the development of PHN.
NPY levels were lower and BDNF and NGF were higher in HZ patients than those in controls. Only NPY levels were lower in patients with PHN (n = 59) compared with those without PHN (n = 123). Age, acute pain severity, and rash area were independent predictors of PHN, as were NPY levels. The area under the curve (AUC) to predict the development of PHN based on the combination of NPY levels and clinical factors was 0.873 (95% CI: 0.805 to 0.940), and the AUC was 0.804 based on only clinical factors (AUC: 0.804, 95% CI: 0.728 to 0.881).
Low plasma NPY levels are a predictor of developing PHN in patients with HZ. Combining clinical predictors with NPY levels may improve predictive accuracy.
大量证据表明神经肽Y（NPY）在神经性疼痛的调节中起关键作用。带状疱疹后神经痛（PHN）的特点是持续时间长、疼痛剧烈且对治疗有显著抵抗性，严重损害患者的生活质量。本研究旨在评估PHN患者血浆NPY水平作为该疾病发生预测生物标志物的潜力。
在2022年2月至2023年12月期间，招募了182例带状疱疹（HZ）患者。还招募了38名无HZ病史的志愿者作为对照。在愈合后3天内评估临床因素、NPY、脑源性神经营养因子（BDNF）和神经生长因子（NGF）。采用逻辑回归分析预测PHN的发生。
HZ患者的NPY水平低于对照组，BDNF和NGF水平高于对照组。与无PHN的患者（n = 123）相比，PHN患者（n = 59）的NPY水平更低。年龄、急性疼痛严重程度和皮疹面积是PHN的独立预测因素，NPY水平也是如此。基于NPY水平和临床因素联合预测PHN发生的曲线下面积（AUC）为0.873（95%CI：0.805至0.940），仅基于临床因素的AUC为0.804（AUC：0.804，95%CI：0.728至0.881）。
血浆NPY水平低是HZ患者发生PHN的预测指标。将临床预测因素与NPY水平相结合可能提高预测准确性。
