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目的观察人免疫球蛋白对老年头面部带状疱疹后遗神经痛(PHN)及外周血中肿瘤坏死因子α(TNF-α)的影响。方法选择老年(≥65岁)头面部带状疱疹住院患者122例,按系统抽样法分为观察组(52例)和对照组(70例)。对照组予以早期常规综合治疗,观察组在对照组基础上予以静脉滴注人免疫球蛋白治疗,记录两组患者痊愈出院后1、2、3个月的PHN发生率及其疼痛视觉模拟评分(VAS)。选择健康老年人20例作为健康对照组,测定两组患者治疗前、后及健康对照组的血清TNF-α水平。结果观察组患者出院后1、2、3个月的PHN发生率均明显少于对照组(P<0.05);治疗后及出院后1、2、3个月VAS评分,观察组均明显低于对照组(P<0.05);治疗后观察组患者血清TNF-α水平明显低于治疗后的对照组(P<0.01),且接近于健康对照组(P>0.05)。结论人免疫球蛋白可减少老年头面部带状疱疹患者的PHN发生并降低其外周血TNF-a水平。
Objective To observe the effect of human immunoglobulin on the incidence of postherpetic neuralgia (PHN) and tumor necrosis factor-α (TNF-α) in the peripheral blood in the elderly. Methods A total of 122 hospitalized elderly patients (≥65 years old) with head and face shingles were selected and divided into observation group (52 cases) and control group (70 cases) by systematic sampling method. The control group was treated with conventional comprehensive treatment. The observation group was treated with intravenous immunoglobulin on the basis of the control group. The incidence of PHN and its pain visual analogue scale VAS). Twenty healthy elderly patients were selected as healthy control group. Serum TNF-α levels were measured before and after treatment in both groups and in healthy control group. Results The incidence of PHN in observation group was significantly lower than that in control group at 1,2,3 months (P <0.05). After treatment and at 1,2,3 months after discharge, the VAS score in observation group was significantly lower than that in control group (P <0.05). After treatment, the level of serum TNF-α in the observation group was significantly lower than that in the control group (P <0.01), and close to the healthy control group (P> 0.05). Conclusion Human immunoglobulin can reduce PHN and reduce the level of TNF-a in peripheral blood in elderly patients with head and face shingles.