急性带状疱疹性神经痛普瑞巴林疗效的影响因素分析

Analysis of Influencing Factors on the Efficacy of Pregabalin in the Treatment of Acute Herpes Zoster Neuralgia

摘要: 目的：探讨急性带状疱疹性神经痛患者普瑞巴林疗效的影响因素。方法：本研究选取2025年1月至2026年4月安徽医科大学第四附属医院接受普瑞巴林治疗的急性带状疱疹性神经痛患者289例，最终纳入177例。根据普瑞巴林连续治疗14天后数字分级评分法(NRS)较入院时基线水平下降幅度分为疗效良好组与疗效不佳组。通过单因素及多因素分析筛选出影响因素，绘制受试者工作特征(ROC)曲线，评估各指标的预测效能。结果：177例患者中，普瑞巴林疗效良好组143例，疗效不佳组34例，疗效不佳发生率为19.2%。其中，两组白球比、血小板计数、外周血中性粒细胞与淋巴细胞比值(NLR)、D-二聚体、年龄、入院时NRS评分等级差异有统计学意义(P < 0.05)，经多因素分析后显示高龄、NLR升高、入院时重度NRS评分等级是普瑞巴林疗效的独立危险因素。ROC曲线分析显示，年龄、NLR及NRS评分等级3项指标联合预测疗效不佳的曲线下面积(AUC)最高(AUC = 0.843, 95% CI 0.765~0.922, P < 0.05)，预测价值优于单一指标。结论：高龄、NLR升高、重度NRS评分等级是普瑞巴林治疗疗效的危险因素，三项指标联合有助于预测普瑞巴林疗效，筛选高危人群。

Abstract: Objective: To explore the influencing factors of the efficacy of pregabalin in patients with acute herpes zoster neuralgia. Methods: In this study, 289 patients with acute herpes zoster neuralgia who were treated with pregabalin in the Fourth Affiliated Hospital of Anhui Medical University from January 2025 to April 2026 were selected, and 177 cases were finally included. According to the Numerical Rating Scale (NRS) after 14 days of continuous treatment of pregabalin compared with the decrease in the baseline level at the time of admission, it is divided into good efficacy group and poor efficacy group. Through univariate and multivariate analyses, we screened for influencing factors, plotted the receiver operating characteristic (ROC) curves, and evaluated the predictive effectiveness of each indicator. Results: Among 177 patients, there were 143 cases in the group with good therapeutic effect of pregabalin and 34 cases in the group with poor therapeutic effect, with an incidence of poor therapeutic effect of 19.2%. Among them, the two groups had statistically significant differences in white blood cell ratio, platelet count, peripheral blood neutrophil and lymphocyte ratio (NLR), D-dimer, age, and NRS score level at the time of admission (P < 0.05). After multivariate analyses, it was shown that the elderly, increased NLR, and severe NRS at the time of admission were independent risk factors for the efficacy of pregabalin. ROC curve analysis shows that the three indicators of age, NLR and NRS score level jointly predict that the curve area (AUC) with poor therapeutic effect is the highest (AUC = 0.843, 95% CI 0.765~0.922, P < 0.05), and the prediction value is better than that of a single indicator. Conclusion: Old age, elevated NLR, and severe NRS score are risk factors for the therapeutic efficacy of pregabalin. The combination of the three indicators helps to predict the efficacy of pregabalin and screen high-risk groups.