系统性红斑狼疮并发带状疱疹的相关危险因素分析

Analysis of related risk factors in patients with systemic lupus erythematosus complicated with herpes zoster

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)并发带状疱疹(herpes zoster,HZ)的相关危险因素,指导临床预防和控制HZ的发生。方法选取于北京军区总医院住院的SLE并发HZ患者26例作为观察组,选取同期住院的SLE患者35例作为对照组,采用单因素分析和多因素非条件Logistic回归对两组患者进行比较分析。结果单因素分析显示:患者病程、淋巴细胞绝对值、激素治疗时间、激素冲击例数、免疫抑制剂治疗时间、1个月内环磷酰胺冲击与否以及T淋巴细胞亚群中分化簇抗原3阳性细胞(cluster of differentiation 3,CD+3)、分化簇抗原4阳性细胞(cluster of differentiation 4,CD+4)、分化簇抗原8阳性细胞(cluster of differentiation 8,CD+8)数值、CD+4/CD+8比值等指标差异均有显著性(P<0.05)。多因素Logistic回归分析显示:激素治疗时间和激素冲击例数与并发HZ呈显著正相关,淋巴细胞绝对值与HZ呈显著负相关(P<0.05)。结论 SLE患者激素使用时间延长、激素冲击治疗以及淋巴细胞绝对值减少是HZ发生的主要危险因素;而患者的病程延长、免疫抑制剂治疗时间延长、1个月内环磷酰胺冲击治疗以及CD+3、CD+4数值下降、CD+8数值升高、CD+4/CD+8比值下降等是次要的危险因素,临床医生应早期给予关注并积极预防HZ的发生。

Objective Exploring the related risk factors in patients with systemic lupus erythematosus complicated with herpes zoster,to prevent and control herpes zoster. Method Enrolled 26 cases of systemic lupus erythematosus patients with herpes zoster as the observation group from inpatients of Department of Rheumatism of General Hospital of Beijing Military Region,35 cases of systemic lupus erythematosus patients hospitalized in the same period as the control group. The clinical data of two groups of successively by single factor analysis and multi factor non conditional Logistic regression analysis. Result Course of disease,the value of lymphocyte,hormone treatment time,the hormone impact cases,immunosuppressive treatment time,whether treated with cyclophosphamide in one month as well as CD^3＋ ,CD^4＋ ,CD^8＋ value,CD^4＋/CD^8＋ ratio were significantly correlated with the occurrence of herpes zoster （ all P〈0. 05）. Multivariate Logistic regression analysis showed that hormone therapy time and number of cases received hormone impact treatment were significantly positive correlation with herpes zoster, absolute value of lymphocyte was negatively correlated with herpes zoster （P〈0. 05）. Conclusion Hormone in patients with systemic lupus erythematosus using time prolonged,the hormone impact treatment and reduction in absolute lymphocyte are major risk factors of herpes zoster occurred;while patients with the extension of course,immunosuppressive treatment time prolonged, treated with cyclophosphamide in one month and CD^3＋ , CD^4＋ decreased and CD^8＋ increased,the numerical value of CD^4＋/CD^8＋ ratio decreased are secondary risk factors,clinicians should give early attention and positive prevention of herpes zoster.