199例带状疱疹后遗神经痛相关危险因素分析

Analysis of risk factors related to postherpetic neuralgia in 199 cases of herpes zoster

目的:分析带状疱疹后遗神经痛(postherpetic neuralgia,PHN)发病相关因素,为临床PHN的预防和治疗提供依据。方法:采用回顾性分析,收集2015年8月至2020年6月广州市第一人民医院199例带状疱疹住院患者临床资料,根据皮疹消失后1个月是否有神经痛,分为PHN组57例和非PHN组142例。收集两组患者的年龄、性别、发病部位、发病时间、临床分型、急性期疼痛程度、血红蛋白水平、白蛋白水平、糖皮质激素使用情况以及是否合并高血压、糖尿病等临床资料。采用单因素及多因素Logistic回归分析。结果:单因素分析示:年龄、发病时间、临床分型、急性期疼痛程度以及白蛋白水平、血红蛋白水平具有统计学差异(P<0.05),而性别、发病部位、糖皮质激素治疗、是否患有高血压、糖尿病则无统计学差异(P>0.05);多因素Logistic回归分析示:血红蛋白水平<120 g/L,年龄≥70岁、发病时间≥7天、临床分型为大疱型、急性期重度疼痛均为PHN发病的独立危险因素,而低白蛋白水平及未使用糖皮质激素不是PHN发病的独立危险因素(P>0.05)。结论:患者年龄≥70岁、发病时间≥7天、急性重度疼痛程度、临床分型为大疱型、血红蛋白水平<120 g/L是PHN发生的危险因素。

Objective:To analyze the related factors of the pathogenesis of postherpetic neuralgia,and to provide the basis for the prevention and treatment of PHN.Methods:The clinical data of 199 patients with herpes zoster in Guangzhou First People's Hospital from August 2015 to June 2020 were retrospectively analyzed.According to whether there was neuralgia within 1 month after the rash disappeared,they were divided into PHN group of 57cases,and 142 cases in the non-PHN group.The factors such as age,gender,location,course,clinical classification,acute pain,hemoglobin level,albumin level,glucocorticoid use and whether combined with hypertension and diabetes were analyzed.Statistical analysis was performed using univariate and multivariate logistic regression.Results:Univariate analysis showed that age,course,clinical classification,acute pain,albumin and hemoglobin levels were statistically significant(P<0.05).Hypertension and diabetes were not statistically significant(P>0.05).Multivariate logistic regression analysis showed that the hemoglobin level<120 g/L,age≥70 years,course≥7 days,clinical types of bullous type,severe pain in acute stage were independent risk factor of PHN.However,low albumin level and lack of glucocorticoid use were not independent risk factors for PHN(P>0.05).Conclusion:The age of patients≥70 years old,course≥7 days,the degree of acute severe pain,the clinical classification of bullous type,and the hemoglobin level<120g/L are the risk factors for the occurrence of PHN.