神经病理性疼痛不同性质疼痛患者血清BDNF、TLR4表达水平差异及其诊断价值分析

摘要 目的：分析神经病理性疼痛（NP）不同性质疼痛患者血清脑源性神经生长因子（BDNF）、Toll受体4（TLR4）表达水平差异及其诊断价值。方法：选取2021年5月～2022年5月本院收治的80例NP患者和100例健康体检者作为研究对象，将NP患者其纳入NP组，将健康体检者纳入对照组，并参照神经病理性疼痛量表（NPS）区分NP组患者的疼痛性质（钝痛20例，不适感28例，深部痛17例，体表痛15例），分别检测两组患者和NP组不同性质疼痛患者的血清BDNF、TLR4表达水平，采用双变量Spearman相关性检验血清BDNF、TLR4与NP不同性质疼痛的相关性，同时建立多因素Logistic模型，分析NP不同性质疼痛的影响因素，并比较其诊断效能。结果：与对照组比较，NP组血清BDNF表达水平较低，TLR4表达水平较高（P＜0.05）；NP钝痛、不适感、深部痛、体表痛的血清BDNF、TLR4表达水平比较（P＜0.05）；血清BDNF与NP钝痛、不适感、深部痛、体表痛呈负相关性，血清TLR4与NP钝痛、不适感、深部痛、体表痛呈正相关性（P＜0.05）；Logistic多因素分析结果显示，BDNF、TLR4均是NP钝痛、不适感、深部痛、体表痛的独立危险因素（P＜0.05）；血清BDNF、TLR4和BDNF+TLR4对NP钝痛、不适感、深部痛、体表痛的ACU均＞0.70。结论：血清BDNF、TLR4与钝痛、不适感、深部痛、体表痛等性质的NP均存在一定关联，在诊断不同NP性质方面具有较高的敏感性和特异性，有利于为临床治疗提供参考依据。

The Expression Levels of Serum BDNF and TLR4 in Patients with Different Types of Neuropathic Pain and Their Diagnostic Value were Analyzed

ABSTRACT Objective: To analyze the expression levels of serum brain-derived neurotrophic factor (BDNF) and Toll receptor 4 (TLR4) in patients with different types of neuropathic pain (NP) and their diagnostic value. Methods: A total of 80 NP patients and 100 healthy subjects admitted to our hospital from May 2021 to May 2022 were selected as the study subjects. NP patients were included in the NP group, and healthy subjects were included in the control group. The neuropathic pain scale (NPS) was used to distinguish the nature of pain in the NP group (20 cases of dull pain, 28 cases of discomfort, 17 cases of deep pain, and 15 cases of body surface pain ). The expression levels of serum BDNF and TLR4 in the two groups of patients and patients with different types of pain in the NP group were detected. Bivariate Spearman correlation was used to test the correlation between serum BDNF, TLR4 and different types of pain in NP.At the same time, a multivariate Logistic model was established to analyze the influencing factors of different types of pain in NP and compare their diagnostic efficacy. Results: Compared with the control group, the expression level of serum BDNF in NP group was lower, and the expression level of TLR4 was higher (P<0.05). There were significant differences in the expression levels of serum BDNF and TLR4 in NP dull pain, discomfort, deep pain and body surface pain(P<0.05). Serum BDNF was negatively correlated with NP dull pain, discomfort, deep pain and body surface pain, while serum TLR4 was positively correlated with NP dull pain, discomfort, deep pain and body surface pain(P<0.05). Logistic multivariate analysis showed that BDNF and TLR4 were independent risk factors for NP dull pain, discomfort, deep pain and body surface pain (P<0.05). The ACU of serum BDNF, TLR4 and BDNF + TLR4 for NP dull pain, discomfort, deep pain and body surface pain were all>0.70. Conclusion: Serum BDNF and TLR4 are associated with NP of blunt pain, discomfort, deep pain, and body surface pain. They have high sensitivity and specificity in the diagnosis of different NP properties, which is beneficial to provide reference for clinical treatment.