Liu Huili, Yuan Yanrong, Wang Jun, Zhang Yan, Yan Yongxing
Hangzhou Third People's Hospital, Hangzhou, China.
Front Neurol. 2025 Aug 4;16:1623229. doi: 10.3389/fneur.2025.1623229. eCollection 2025.
Postherpetic neuralgia (PHN) typically occurs in immunocompromised patients. However, there is a lack of prospective studies involving large samples of immunocompetent individuals. A prospective study was conducted to ascertain the association between serum levels of various markers and the occurrence of PHN in acute herpes zoster (HZ) patients with immunocompetent.
A total of 887 acute HZ patients with immunocompetent who were admitted to Hangzhou Third People's Hospital between April 2021 and December 2023 were selected. Peripheral venous blood at their initial visit was collected and the levels of various serum markers were detected. According to whether PHN occurred or not during follow-up, the participants were divided into PHN group and non-PHN group. Multivariate logistic regression analysis was used to screen the influencing factors of PHN.
Two hundred and seventeen cases (24.5%) developed PHN. Compared with the non-PHN group, age, numerical rating scale (NRS) scores, levels of C reactive protein (CRP) and homocysteine (HCY) in PHN group were significantly increased ( < 0.01), while CD3 ( < 0.05), CD4 ( < 0.01), CD4/CD8 ratios ( < 0.05), albumin levels ( < 0.01), and albumin/globulin (A/G) ratios ( < 0.05) were significantly decreased. Multivariate logistic regression analysis showed that age, NRS scores, levels of CRP, and HCY were independent risk factors for PHN among acute HZ patients with immunocompetent. ROC curve analysis showed that the sensitivity and specificity of combined with age, NRS scores, CRP and HCY levels in predicting PHN were 68.4 and 74.1%, respectively.
Age and the severity of pain at the time of onset were also the risk factors for PHN in acute HZ patients with immunocompetent. The levels of serum CRP and HCY as potential biomarkers may have certain reference value for predicting the occurrence of PHN in acute HZ patients with immunocompetent.
带状疱疹后神经痛（PHN）通常发生在免疫功能低下的患者中。然而，缺乏涉及大量免疫功能正常个体的前瞻性研究。进行了一项前瞻性研究，以确定各种标志物的血清水平与免疫功能正常的急性带状疱疹（HZ）患者发生PHN之间的关联。
选取2021年4月至2023年12月期间入住杭州市第三人民医院的887例免疫功能正常的急性HZ患者。在他们初次就诊时采集外周静脉血，并检测各种血清标志物的水平。根据随访期间是否发生PHN，将参与者分为PHN组和非PHN组。采用多因素logistic回归分析筛选PHN的影响因素。
217例（24.5%）发生了PHN。与非PHN组相比，PHN组的年龄、数字评分量表（NRS）评分、C反应蛋白（CRP）和同型半胱氨酸（HCY）水平显著升高（<0.01），而CD3（<0.05）、CD4（<0.01）、CD4/CD8比值（<0.05）、白蛋白水平（<0.01）和白蛋白/球蛋白（A/G）比值（<0.05）显著降低。多因素logistic回归分析显示，年龄、NRS评分、CRP水平和HCY是免疫功能正常的急性HZ患者发生PHN的独立危险因素。ROC曲线分析显示，年龄、NRS评分、CRP和HCY水平联合预测PHN的敏感性和特异性分别为68.4%和74.1%。
年龄和发病时的疼痛严重程度也是免疫功能正常的急性HZ患者发生PHN的危险因素。血清CRP和HCY水平作为潜在的生物标志物，可能对预测免疫功能正常的急性HZ患者发生PHN具有一定的参考价值。
