CAJ | 학술논문

目的检测老年带状疱疹患者急性期外周血T细胞亚群水平，观察患者急性期机体细胞免疫状态与带状疱疹急性期疼痛(AHP)和后遗神经痛(PHN)的关系。方法选择急性期老年带状疱疹患者60例，根据AHP视觉模拟评分(visual analogue scales,VAS)分为轻中度AHP组：VAS评分≤6分，重度AHP组：VAS评分＞6分；再根据随访结果是否发生带状疱疹后PHN分为非PHN组和PHN组。选取年龄、性别相匹配的门诊健康体检者25例作为对照组。记录患者AHP最严重时VAS评分，采用流式细胞测定技术测定急性期外周血T细胞亚群CD3+、CD4+和CD8+百分比及计算CD4 +/CD8+比值。结果各组年龄、性别差异无统计学意义(P＞0.05);轻中度AHP组、重度AHP组、非PHN组和PHN组CD3+、CD4+、CD8+表达与对照组比较均降低(P＜0.05)，重度AHP组CD4+表达低于轻中度AHP组(P＜0.05) ;CD4 +/CD8+比值轻中度AHP组、非PHN组均高于对照组(P＜0.05),重度AHP组低于轻中度AHP组(P＜0.05),PHN组低于非PHN组(P＜0.05);PHN组AHP VAS评分高于非PHN组(P＜0.05)。结论老年带状疱疹患者急性期普遍存在细胞免疫功能低下，表现为T细胞亚群百分比降低；重度AHP患者细胞免疫状态更低。PHN患者在疱疹急性期存在更严重的局部损害和更低下免疫应答。
목적 검측노년대상포진환자급성기외주혈T세포아군수평，관찰환자급성기궤체세포면역상태여대상포진급성기동통(AHP)화후유신경통(PHN)적관계。 방법 선택급성기노년대상포진환자60례，근거AHP시각모의평분(visual analogue scales,VAS)분위경중도AHP조：VAS평분≤6분，중도AHP조：VAS평분＞6분；재근거수방결과시부발생대상포진후PHN분위비PHN조화PHN조。선취년령、성별상필배적문진건강체검자25례작위대조조。기록환자AHP최엄중시VAS평분，채용류식세포측정기술측정급성기외주혈T세포아군CD3+、CD4+화CD8+백분비급계산CD4 +/CD8+비치。 결과 각조년령、성별차이무통계학의의(P＞0.05);경중도AHP조、중도AHP조、비PHN조화PHN조CD3+、CD4+、CD8+표체여대조조비교균강저(P＜0.05)，중도AHP조CD4+표체저우경중도AHP조(P＜0.05) ;CD4 +/CD8+비치경중도AHP조、비PHN조균고우대조조(P＜0.05),중도AHP조저우경중도AHP조(P＜0.05),PHN조저우비PHN조(P＜0.05);PHN조AHP VAS평분고우비PHN조(P＜0.05)。 결론 노년대상포진환자급성기보편존재세포면역공능저하，표현위T세포아군백분비강저；중도AHP환자세포면역상태경저。PHN환자재포진급성기존재경엄중적국부손해화경저하면역응답。
Objective To study T lymphocyte subsets levels in acute zoster patients and investigate its relation to the zoster associated pain.Methods According to the visual analogue scales(VAS) in the acuter phase, 60 patients with herpes zoster were divided into two groups: group A (VAS≤6) and group B (VAS＞6). According to the follow-up results, patients were divided into another two groups: group C (PHN not developed) and group D (PHN developed). 25 healthy volunteers with a similar age and gender range as the patients were recruited as control group. T lymphocyte subsets were detected by fluorescence-activated cell sorter (FACS). Results There was no significant difference in gender and age between groups (P＞0.05). T lymphocyte subsets were significantly decreased in four groups compared with the control group (P＜0.05), and the CD4 +subsets in group B were significantly decreased compared with group A (P＜0.05). The CD4 +/CD8 + ratios were significantly higher in group A and C than in control group, higher in group A than B and higher in group C than in group D (P＜0.05). The visual analogue scales(VAS) in group D were significantly higher than in group C (P＜ 0.05).Conclusions Cellular immunity function is decreased with the lower percent of the T lymphocytes subsets in the elderly patients with acute herpes zoster, especially in severe patients. The CD4 +/CD8 + ratios and the visual analogue scales may be associated with the the risk of post herpetic neuralgia.