中华皮肤科杂志 ›› 2016, Vol. 49 ›› Issue (11): 806-809.

• 研究报道 • 上一篇    下一篇

播散性带状疱疹53例临床特点分析

何彩凤1,慈超1,唐彪1,常小丽2,强娣3,季必华4   

  1. 1. 皖南医学院弋矶山医院皮肤科
    2.
    3. 皖南医学院弋矶山医院皮肤性病科
    4. 皖南医学院附属弋矶山医院
  • 收稿日期:2016-02-15 修回日期:2016-05-01 出版日期:2016-11-15 发布日期:2016-10-28
  • 通讯作者: 季必华 E-mail:jibihua@aliyun.com

Clinical analysis of 53 cases of disseminated herpes zoster

  • Received:2016-02-15 Revised:2016-05-01 Online:2016-11-15 Published:2016-10-28

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摘要：

目的 探讨播散性带状疱疹的诱因、临床特点及带状疱疹后遗神经痛的影响因素。方法 对2012—2015年收治的53例播散性带状疱疹患者和809例普通带状疱疹患者的临床资料进行回顾性分析，采用logistic回归模型分析播散性带状疱疹的发生、疼痛程度、带状疱疹后遗神经痛的影响因素。结果 播散性带状疱疹患者年龄（56.66 ± 17.24）岁，普通带状疱疹患者组（56.50 ± 15.51）岁，两组差异无统计学意义（t = 0.071，P > 0.05），但两组性别分布差异有统计学意义（χ2 = 8.16，P = 0.004）。播散性带状疱疹组出现大疱（15.09%）、脓疱（47.17%）、发热（30.19%）的比例显著高于普通带状疱疹组（3.58%、26.82%、8.03%），差异均有统计学意义（χ2 = 16.04、10.20、28.68，均P < 0.01）。播散性带状疱疹组入院时疼痛评分中位数（P25 ~ P75）为6（4 ~ 7.5）分，也高于普通带状疱疹组［5（3 ~ 7）分］，差异有统计学意义（Z = -3.460，P = 0.001）。Logistic回归分析显示，性别、年龄、劳累、HIV感染与带状疱疹皮疹播散有关（P < 0.05），尤其是HIV感染（OR = 5.570，95% CI：1.196 ~ 25.939，P = 0.029）、性别（OR = 0.166，95% CI：0.029 ~ 0.945，P = 0.043）、年龄（OR = 1.064，95% CI：1.010 ~ 1.119，P = 0.019）及抗病毒治疗天数（OR = 0.669，95% CI：0.505 ~ 0.885，P = 0.005）是带状疱疹后遗神经痛的影响因素。结论 男性、老年、劳累、HIV感染是皮疹播散的影响因素，尤其是HIV感染是播散性带状疱疹的高危因素。男性、老年及抗病毒治疗天数是带状疱疹后遗神经痛的相关因素。

关键词: 神经痛, 带状疱疹后

Abstract:

He Caifeng, Ci Chao, Tang Biao, Chang Xiaoli, Qiang Di, Ji Bihua Department of Dermatology, Yijishan Hospital, Wannan Medical College, Wuhu 241000, Anhui, China Corresponding author: Ji Bihua, Email: jibihua@aliyun.com 【Abstract】 Objective To investigate the predisposing factors and clinical features of disseminated herpes zoster, and to explore factors influencing postherpetic neuralgia. Methods Clinical data were collected from 53 patients with disseminated herpes zoster and 809 patients with common herpes zoster between 2012 and 2015, and analyzed retrospectively. Logistic regression analysis was used to assess factors influencing the occurrence of and pain intensity in disseminated herpes zoster, as well as the occurrence of postherpetic neuralgia. Results No significant difference in patients′ age was observed between the disseminated and common herpes zoster groups （56.66 ± 17.24 vs. 56.50 ± 15.51 years, t = 0.071, P > 0.05）, but there was a significant difference in the gender ratio between the two groups （χ2 = 8.16, P = 0.004）. The incidence rates of bullae, pustules and fever were all significantly higher in the disseminated herpes zoster group than in the common herpes zoster group （15.09% vs. 3.58%, χ2 = 16.04, P < 0.01; 47.17% vs. 26.82%, χ2 = 10.20, P < 0.01; 30.19% vs. 8.03%, χ2 = 28.68, P < 0.01）. The disseminated herpes zoster group also showed significantly higher pain scores at admission compared with the common herpes zoster group （Median ［P25 - P75］: 6 ［4 - 7.5］ vs. 5［3 - 7］, Z = -3.460, P = 0.001）. Logistic regression analysis revealed that gender, age, fatigue and HIV infection were significantly associated with the occurrence of disseminated herpes zoster （all P < 0.05）. Additionally, HIV infection （OR = 5.570, 95% CI: 1.196 - 25.939, P = 0.029）, gender （OR = 0.166, 95% CI: 0.029 - 0.945, P = 0.043）, age （OR = 1.064, 95% CI: 1.010 - 1.119, P = 0.019） and the number of days that antiviral therapy lasted （OR = 0.669, 95% CI: 0.505 - 0.885, P = 0.005） were all factors influencing the occurrence of postherpetic neuralgia. Conclusion Male, old age, fatigue and especially HIV infection are risk factors for the occurrence of disseminated herpes zoster, and male, old age and antiviral therapy duration may be associated with the occurrence of postherpetic neuralgia.