1. 2025;28;431-438Predictive Value of Preoperative Antioxidant Levels in Postherpetic Neuralgia: A Retrospective Study
   Retrospective Study
   JiaYu Yue, PhD, and Ming Yao, PhD.

BACKGROUND: Herpes zoster (HZ) presents as painful blisters caused by the reactivation of the varicella-zoster virus. Postherpetic neuralgia (PHN) is a challenging complication of HZ. Oxidative stress, implicated in various skin diseases, may play a role in PHN, motivating the investigation of blood antioxidants as potential predictors of the complication. Only a limited amount of research has explored the connection between serum antioxidants and HZ outcomes.

OBJECTIVES: To examine the impact of specific serum antioxidants on the development of PHN.

STUDY DESIGN: A retrospective, observational study. 

SETTING: The study was carried out in the Pain Department of the First Hospital Affiliated to Jiaxing College in Jiaxing, China.

METHODS: A total of 305 patients were included in the study, with 149 classified into the PHN group and 156 into the non-PHN group. Demographic information such as gender, age, disease duration, hospitalization, affected site, number of segments involved, complications, and treatment details were gathered. Moreover, common hematological data, including patients’ levels of albumin (ALB), total bilirubin (TBIL), uric acid (UA), homocysteine (Hcy), and C-reactive protein (CRP) upon admission were recorded. Factors influencing prognosis were analyzed through both univariate and multivariate logistic regression analyses. Furthermore, a receiver operating characteristic (ROC) curve was constructed to evaluate the predictive potential of ALB and TBIL for prognosis.

RESULTS: In the univariate analysis, age (odds ratio [OR] = 2.386, P = 0.000), disease duration (OR = 2.182, P = 0.001) and levels of albumin (OR = 0.284, P = 0.000), and TBIL (OR= 0.224, P = 0.000) were found to be correlated with PHN. Multifactorial logistic regression analysis revealed that an age exceeding 60 years (OR = 1.979, P = 0.012), ALB levels >= 44 g/L (OR = 0.278, P = 0.000), and TBIL levels >= 9.2 mu-mol/L (OR = 0.302, P = 0.000) were independent factors associated with PHN. The ROC curve demonstrated high predictive values for PHN with ALB and TBIL.

CONCLUSIONS: This study highlights the significant association between serum antioxidants, specifically ALB and TBIL, and the prognosis of PHN in patients with HZ.

LIMITATIONS: The nonrandomized, single-center, and retrospective design are major limitations of this study.

KEY WORDS: albumin, total bilirubin, oxidative stress, antioxidants, postherpetic neuralgia, predictive value