目的:分析富血小板血浆(PRP)肌筋膜内注射治疗带状疱疹后神经痛(PHN)的疗效.方法:选取2019年1月至2021年12月收治的60例老年胸腰段PHN患者,所有患者均接受肌筋膜内注射PRP治疗.记录所有患者的治疗疗效和不良反应发生情况,同时比较治疗前后的疼痛数字评分(NRS)、匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)及抑郁自评量表(SDS)等量表评分,以及血清疼痛介质水平.结果:所有患者的治疗总有效率为93.33％,不良反应总发生率为18.33％.随访3个月,治疗后1个月和3个月,所有患者的NRS和PSQI评分均明显低于治疗前,差异有统计学意义(P＜0.05);治疗后3个月,所有患者的SAS和SDS评分均明显低于治疗前,差异有统计学意义(P＜0.05),血清β-EP、NT水平均明显高于治疗前,差异有统计学意义(P＜0.05),血清CGRP、VGF等水平均明显低于治疗前,差异有统计学意义(P＜0.05).结论:PRP肌筋膜内注射治疗PHN患者疗效显著,能明显减轻疼痛程度,提升睡眠质量,改善患者情绪状态,且治疗安全性高,值得临床推广应用.

Objective To investigate the risk factors of sleep apnea syndrome combined with cerebral apoplexy.Methods Thirty-nine patients with obstructive sleep apnea syndrome combined with cerebral apoplexy,admitted to our hospital from June 2014 to June 2015,and 45 patients with obstructive sleep apnea syndrome were selected in our study.Polysomnography (PSG) was performed,and lowest blood oxygen saturation (SpO2),max apnea time (SA~) and sleep apnea hypoventilation index (AHI) were recorded in all patients;multivariable Logistic regression analysis was used to analyze the risk factors of sleep apnea syndrome combined with cerebral apoplexy.Results There were significant differences in smoking rate,body mass index (BMI) and fibrinogen (Fib),low density lipoprotein cholesterol (LDL-C) and superoxide dismutase (SOD) levels between the two groups (P＜0.05).PSG results showed that the SpO2,SAmax and AHI indicators were statistically different between the two groups (P＜0.05).Multivariate Logistic regression analysis showed that BMI,SAmax,SpO2 and AHI were the risk factors of sleep apnea syndrome combined with cerebral apoplexy (OR=4.685,95％CI:3.658-6.325,P=0.017;OR=3.569,95％CI:2.875-3.968,P=0.024;OR=4.125,95％CI:4.025-4.569,P=0.034;OR=4.253,95％CI:4.135-5.032,P=0.036).Conclusion Patients with obesity or severe anoxia have high risk of sleep apnea syndrome combined with cerebral apoplexy.