老年带状疱疹患者并发后遗神经痛的危险因素

Analysis on Risk Factors of Postherpetic Neuralgia in Older Patients

目的分析老年带状疱疹患者发生后遗神经痛(Postherpetic neuralgia,PHN)的危险因素。方法收集356例老年带状疱疹患者的临床资料,根据是否发生PHN分为PHN组和无PHN组,记录患者年龄、性别、前驱症状、急性期疼痛强度、皮疹程度、抗病毒和止痛治疗情况、合并症及吸烟史。将组间差异有统计学意义的因素进行Logistic回归分析,筛选PHN发生的危险因素。结果 140例患者发生PHN,发病率为39.3%。2组患者在年龄、性别、急性期疼痛强度、皮疹程度、早期抗病毒治疗、吸烟史上比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示高龄、女性、严重的的急性疼痛和有吸烟史和PHN的发生呈正相关,早期抗病毒治疗是PHN的有利因素。结论对高龄、女性、急性期疼痛剧烈及有吸烟史的带状疱疹患者要积极治疗,早期抗病毒治疗能有效预防PHN的发生。

Objective In order to evaluate the risk factors for postherpetic neuralgia in older patients. Methods According to the development of PHN,356 herpes zoster(HZ) patients were divided into PHN group and non-PHN group. The following data were analyzed:age,sex,prodrome,pain intensity,the extent of rash,antiviral and analgesic therapy,complication and smoking history. Logistic regression analysis was performed in factors that were statistically significant to screen PHN-related risk factor. Results Totally 140 patients had PHN,the incidence was 39.3%. There was significant difference between the two groups in age,gender,pain intensity,early antiviral therapy,smoking history(P<0.05). Logistic regression analysis showed that the risk factors for PHN including advanced age,female patients,more severe acute pain and smoking history. The early antiviral therapy was favorable factors. Conclusion Paying attention to the elderly and women patients with severe acute pain and a history of smoking,using antiviral medicine as soon as possible,could avoid PHN effectively.