| BackgroundHerpes zoster is caused by varicella-zoster virus(VZV).Its typical clinical manifestations are erythema and clustered blisters,occurring unilaterally and accompanied by neuralgia,doctors can make a diagnosis according this.However,there are still some special types of herpes zoster without skin lesions,such as setback herpes zoster,ocular herpes zoster,herpes zoster meningitis,etc.The diagnosis of such diseases often depend on laboratory tests,such as detection of VZV DNA or antibody in cerebrospinal fluid or blood of patients.VZV DNA also exists in saliva of patients with herpes zoster.Detection of VZV DNA in saliva may be helpful to diagnose the related diseases caused by VZV and can avoid invasive tests,such as lumbar puncture.ObjectiveTo explore the usefulness of saliva in the diagnosis of herpes zoster,analyze the influencing factors of VZV DNA load in saliva and its relationship with patients'clinical symptoms,the levels of IL-2,IL-6,IL-18 and PHN,to explore the clinical applicatio n value of saliva in evaluating the patient's condition and prognosis,provide new ideas for the clinical management of herpes zoster patients.Methods1.Sixty-three patients with herpes zoster who visited our hospital from January 2018 to August 2019 were included.Patients were split into mild and moderate group and severe group based on the clinical score table.Saliva,blood and the skin tissue were collected.30 healthy adults were collected as control group.Real-time fluorescence quantitative PCR was used to detect varicella-zoster virus load in saliva and serum,and the viral load of different groups was compared by SPSS software.The virus particles in saliva and skin lesion were observed by TEM.2.The levels of cytokines IL-2,IL-6 and IL-18 in serum were detected by ELISA.The occurrence of PHN was recorded after the skin lesions of patients subsided for 3 months,the influencing factors of VZV DNA load in saliva and serum and their relationships with cytokines IL-2,IL-6,IL-1 8 and PHN were analyzed statistically.Results1.T he positive cases of VZV DNA in saliva and blood of patients group were 56 and 55 respectively,with the positive rates were 89%and 87%respectively.The positive cases of VZV DNA in saliva and serum of control group were 5 and 9 respectively,and the positive rates were 17%and 30%respectively.The VZV DNA load in saliva and serum in patients group were higher than that in control group(P<0,05).The VZV DN A load of patients with herpes zoster in severe group was higher than that in mild and moderate groupwhether in saliva or blood(P<0.05).Virus particles were found in saliva of patients with herpes zoster by TEM,which has the same shape and diameter as virus particles in skin lesion tissue,while no virus particles were found in saliva of control group.2.The VZV DNA load in saliva is affected by patient's sex and age.Viral load in blood is related to patients' age,history of prodromal pain and basic disease.There was no correlation between VZV DNA load whether in saliva and blood and the levels of cytokines(P>0.05).The age,disease score and VZV DNA.load in serum of PHN group were higher than those of non-PHN group(P<0.05),while the difference of VZV DNA load in saliva between the two groups was not statistically significant(P>0.05).ConclusionThe positive rate of VZV DNA in saliva of herpes zoster patients is high,the viral load is related to clinical symptoms of patients,so saliva can be used for the diagnosis and evaluation of disease condition of herpes zoster;The occurrence of PHN can be predicted according to the comprehensive factors such as the age of patients,the severity of the disease,VZV DNA load,etc. |
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