带状疱疹后遗神经痛患者糖代谢异常情况的研究

目的：调查并分析带状疱疹后遗神经痛（PHN）患者糖代谢异常情况。方法选取确诊胸部PHN患者31例，及其无疼痛、无已知神经功能障碍和糖尿病史的配偶或直系亲属62例作为对照组，记录两组一般资料以及体重指数（BMI）、腰围、糖化血红蛋白（HbA1c）；检测PHN患者空腹和口服葡萄糖耐量试验（2h- OGTT）后血糖和胰岛素水平以评价小纤维神经病。结果两组性别、年龄、空腹血糖和胰岛素水平、腰围、稳态模型评价（HOMA）指数、HbA1c水平的差异均无统计学意义（均P＞0.05）；两组糖代谢异常（糖耐量受损＋糖尿病）发生率，尤其糖耐量受损的差异有统计学意义（P＜0.05）；31例PHN患者中发现有小纤维神经病14例，与糖代谢正常者相比，合并糖代谢异常，尤其合并糖耐量受损患者中小纤维神经病发生率增加，差异有统计学意义（P＜0.05）。结论 PHN患者糖代谢异常明显增加，PHN合并糖代谢异常（糖耐量受损＋糖尿病），尤其合并糖耐量受损患者小纤维神经病发生率增加。

Abnormal glucose metabolism in patients with postherpetic neuralgia

Objective To analyze glucose metabolism in patients with postherpetic neuralgia （PHN）. Methods 31 pa-tients with thoracic PHN （PHN group） and 62 healthy subjects （control group） were enrolled in the study. The anamnestic data （dietary habits, life style, drug use）, demographic information （age, sex）, body mass index, waist circumference and serum HbA1c were documented in both groups;the glucose and insulin levels at fasting and after 2h- OGTT were measured and skin thoracic biopsy was performed for smal fiber neuropathy in PHN groups. Results Medical records and demographic information were not significantly different between two groups（P〉0.05）. 2h- OGTT showed that the prevalence of glucose metabolism abnormal-ity was significantly higher in PHN group than that in control group, especial y for impaired glucose tolerance （IGT） （P〈0.05）. Skin biopsy detected smal fibers neuropathy in 14 out of 31 patients with PHN;PHN patients with abnormal glucose metabolism, es-pecial y IGT had higher prevalence of smal fibers neuropathy （P〈0.05）. Conclusion Patients with PHN have higher prevalence of abnormal glucose metabolism and PHN Patients with abnormal glucose metabolism have higher prevalence of smal fibers neuropathy.