带状疱疹后遗神经痛的危险因素分析

Analysis of risk factors of postherpetic neuralgia

目的评估带状疱疹患者发生后遗神经痛(postherpetic neuralgia,PHN)的相关风险因素。方法收集安徽医科大学第一附属医院皮肤性病科2017年1月至2018年1月间确诊的带状疱疹住院患者256例,采用问卷调查及电话等随访方式,综合评估患者发病年龄、性别等因素与PHN的关联性。结果 256例患者最终随访完成197例,其中73例患者发生PHN(37.05%)。最终多因素Logistic回归分析结果显示:年龄>50岁(OR:8.780;95%CI:3.057~25.218;P<0.001);皮损分布体侧(OR:0.453;95%CI:0.223~0.922;P=0.029);皮损继发细菌感染者(OR:2.942;95%CI:1.266~6.835;P=0.012);疼痛等级(OR:4.148;95%CI:2.219~7.756;P<0.001)是PHN发生的独立危险因素。发病3个月后仍伴有瘙痒(post-herpeticitch,PHI)者约占15%,Spearman秩相关检验提示其与PHN无相关关系(r=0.097,P=0.177>0.05)。结论患者发病年龄、原发皮损继发细菌感染、急性期疼痛等级可能是PHN发生的独立风险因素。PHI与PHN两者之间无相关性。

Objective To evaluate the risk factors for postherpetic neuralgia(PHN)in patients with herpes zoster.Methods A total of 256 inpatients with herpes zoster diagnosed in Department of Dermatology,The First Affiliated Hospital of Anhui Medical University from January 2017 to January 2018 were collected.Questionnaire survey,telephone follow-up and other methods were used to comprehensively evaluate the correlation between age of onset,gender and PHN.Results 197 patients were followed up,among which 73 patients developed PHN(37.05%).The final multivariate Logistic regression analysis results showed that the age was over 50 years old(OR:8.780;95%CI:3.057~25.218;P<0.001),Body side of skin lesion distribution(OR:0.453;95%CI:0.223~0.922,P=0.029);Bacterial infection secondary to skin lesions(OR:2.942;95%CI:1.266~6.835;P=0.012),and Pain rating(OR:4.148;95%CI:2.219~7.756;P<0.001)is an independent risk factor for PHN.About 15%of patients still had post-herpetic itch(PHI)3 months after onset.Spearman rank correlation test suggested that there was no correlation between it and PHN(r=0.097,P=0.177>0.05).Conclusion Age of onset,secondary bacterial infection of primary lesions and pain level in acute stage may be independent risk factors for PHN.No correlation exists between PHI and PHN.