晚期癌症患者化疗后带状疱疹病毒感染状况分析

Analysis of the status of herpes zoster virus infection after chemotherapy in patients with advanced cancer

目的分析晚期癌症患者化疗后带状疱疹病毒感染状况。方法收集2010年6月-2016年6月于医院进行化疗的晚期癌症患者的临床资料,化疗患者2280例。分析并发带状疱疹病毒感染患者的临床特点、并发原因、治疗方法、化疗后的恢复效果及生存状况。结果化疗后发生带状疱疹病毒感染的患者82例,感染率3.60%,患者由于化疗导致免疫力低下引起带状疱疹病毒感染,且带状疱疹的感染率低于带状疱疹的正常发病率;均经过3~6个化疗周期,于化疗期间或化疗结束后45d内发生带状疱疹感染;对82例感染患者进行及时治疗,5例患者治疗后5d内症状改善,68例患者10d内症状改善,9例患者15d内改善,平均改善时间为(8.32±2.51)d,平均治愈时间为(12.92±4.15)d;31例患者发生不良反应,表现为后遗神经痛,5个月后18例患者不良反应症状消失。结论晚期癌症患者在化疗期间或化疗后免疫力下降诱发带状疱疹病毒感染,患者及时治疗能一定程度改善感染状况,但治疗期间易发生不良反应,治疗不及时或因患者自身免疫力低下等问题,易导致带状疱疹后遗神经痛等后遗症。

OBJECTIVE To explore the status of viral infection of herpes zoster after chemotherapy in patients with advanced cancer. METHODS The clinical data of 2280 patients with advanced cancer and chemotherapy in our hos- pital from Jun. 2010 to Jun. 2016 were collected. The clinical characteristics of the patients complicated with her- pes zoster virus infection, causes of the disease, treatment methods, recovery effect after chemotherapy and sur- vival status were analyzed. RESULTS There were 82 patients with herpes zoster virus infection after chemothera- py, and the infection rate was 3.60%. Patients with chemotherapy occurred herpes zoster virus infection due to low immunity, and herpes zoster concurrency rate was lower than the normal incidence of herpes zoster. Herpes zoster infection occurred within 4：5 d during or after chemotherapy, during the 3- 6 chemotherapy cycles. After treatment in time, of 82 cases of infected patients , The symptoms were improved in 5 patients within 5d after treatment, in 68 patients within 10d after treatment, and in 9 patients within 15d after treatment, the average im- provement time was （8.32±2.51） d, and the average cure time was （12.92±4.15） d. Totally 31 cases of patients had adverse reactions, and 18 patients with adverse symptoms disappeared after 5 months.CONCLUSION Patients with advanced cancer have herpes zoster virus infection induced by the decline of immunity during chemotherapy or after chemotherapy, timely treatment of patients can improve the infection status to a certain extent, but it is easy to have adverse reactions during the treatment. The treatment is not timely or the patienfs own immunity is low and other issues, can easily lead to postherpetic neuralgia and other sequelae.