带状疱疹后遗神经痛的脊髓发病机制的研究进展

摘要

Postherpetic neuralgia(PHN)is a kind of pathological pain syndrome after the recovery of acute herpes zos-ter(HZ).Although researches in peripheral sensitization and central processing have progressed currently,clinical treatment is not satisfying because of its complex pathogenesis,bringing great distress to patients.Varicella-zoster virus(VZV)is the pathogen of PHN,and its latency and activation in dorsal root ganglion are associated with protein expression. The structural and functional changes in spinal dorsal horn are direct causes of central sensitization.Spinal cord and the supraspinal struc-tures are involved in the transmission and processing of pain,producing moderate facilitation or inhibition.In recent years, studies of participation of glial cells in PHN are increasing,providing theoretical basis for clinical treatment of PHN,espe-cially spinal cord intervention.%带状疱疹后遗神经痛(PHN)是急性带状疱疹(HZ)痊愈后,遗留下来的一种病理性疼痛综合征.目前,虽然针对PHN在外周敏化和中枢处理等方面的研究有一定进展,但由于其发病机制复杂,临床治疗效果不佳,为患者带来极大困扰.水痘-带状疱疹病毒(VZV)是PHN的病原体,VZV在背根神经节的潜伏和激活与其蛋白表达相关.脊髓背角的结构与功能变化是致使中枢敏化的直接原因.脊髓及脊髓上结构参与痛觉的传递和加工过程,对疼痛信息产生适度的易化或抑制.近年来,针对脊髓胶质细胞参与PHN的研究日趋增多,为PHN的临床治疗特别是脊髓干预提供了理论依据.