带状疱疹后神经痛危险因素及GCH1基因多态性

目的探讨带状疱疹后神经痛(PHN)危险因素及三磷酸鸟苷环化水解酶1(GCH1)基因多态性。方法选择南阳市第一人民医院皮肤科2016年1月-2020年3月收治带状疱疹患者103例为研究对象,根据是否发生PHN分为PHN组(n=31)和非PHN组(n=72)。采用聚合酶链式反应-限制性片段长度多态性对GCH1基因rs3783641位点多态性进行检测。结果单因素分析结果显示,PHN与应用激素史、初治时间、抑郁程度、焦虑程度存在关联(P<0.05),与年龄、皮损面积、性别、发病部位、治疗疗程无关;多元Logistic回归分析结果显示,无应用激素史、抑郁程度较高、焦虑程度较高是带状疱疹发生PHN的独立危险因素(P<0.05);PHN组患者与非PHN组患者GCH1基因rs3783641位点基因型分布总体差异具有统计学意义(Z=1.646,P=0.009);PHN组AT基因型频率低于非PHN组,TT基因型、T等位基因频率高于非PHN组,差异具有统计学意义(P<0.05);不同基因型AA、AT、TT视觉模拟评分(VAS)分别为(3.18±1.09)分、(4.12±1.34)分、(5.75±1.62)分,总体差异具有统计学意义(P<0.05)。结论PHN与应用激素史、初治时间、抑郁程度、焦虑程度存在关联,GCH1基因多态性与PHN发生及疼痛程度存在关联,可作为筛查指标。

Risk factors for postherpetic neuralgia and gene polymorphism of GCH1

OBJECTIVE To explore the risk factors for postherpetic neuralgia(PHN)and the polymorphism of guanosine triphosphate(GTP)cyclohydrolase1(GCH1)gene.METHODS A total of 103 patients with herpes zoster who were treated in the department of dermatology of Nanyang First People’s Hospital of Henan Province from Jan 2016 to Mar 2020 were recruited as the study subjects and divided into the PHN group with 31 cases and the non-PHN group with 72 cases according to the status of PHN.The rs3783641 locus polymorphism of GCH1 gene was detected by using polymerase chain reaction-restriction fragment length polymorphism.RESULTS The result of univariate analysis showed that PHN was associated with use of hormone,initial treatment time,degree of depression and degree of anxiety(P<0.05)but was not associated with area of skin lesion,gender,location of onset or treatment course.Multivariate logistic regression analysis indicated that no history of use of hormones,high degree of depression and high degree of anxiety were independent risk factors for PHN in the patients with herpes zoster(P<0.05).There was significant overall difference in genotype distribution of rs3783641 locus of GCH1 gene between the PHN group and the non-PHN group(Z=1.646,P=0.009).The frequency of AT genotype of the PHN group was significantly lower than that of the non-PHN group,the frequencies of TT genotype and T allele of the PHN group were significantly higher than those of the non-PHN group(P<0.05).The visual analogue scores(VAS)of the patients with genotype AA,AT and TT were respectively(3.18±1.09)points,(4.12±1.34)points,and(5.75±1.62)points,and there was significant overall difference(P<0.05).CONCLUSION PHN is associated with use of hormones,initial treatment time,degree of depression and degree of anxiety.The GCH1 gene polymorphism is associated with the incidence of PHN and degree of pain,and it can be used as a screening index.