老年带状疱疹后神经痛患者的实验性指标分析

Analysis of experimental indexes in elderly patients with postherpetic neuralgia

目的探讨带状疱疹(HZ)老年患者发展为带状疱疹后神经痛(PHN)的常见因素,以便在临床诊疗中识别高危人群并及时介入干预。方法选取该院皮肤与性病科门诊2021年6—12月收治的187例老年HZ患者的临床资料进行回顾性分析。其中首诊后发展为PHN的患者40例(PHN组),未发展为PHN的患者147例(无PHN组)。统计2组患者的临床资料,使用单因素和多因素分析筛选出可能影响PHN发病的独立危险因素。结果单因素方差分析显示,2组患者血清同型半胱氨酸(Hcy)、中性粒与淋巴细胞比值(NLR)、C反应蛋白(CRP)水平比较,差异均无统计学意义(P>0.05),而血清D-二聚体(D-dimer)、白蛋白与球蛋白比值(AGR)、维生素B 12、白细胞介素-6(IL-6)、CD4+T、1,25-(OH)2-D 3、总胆红素(TBIL)水平比较,差异均有统计学意义(P<0.05)。二元logistic回归分析显示,除IL-6≥7 pg/mL、1,25-(OH)2-D 3<30 ng/mL、TBIL≥1.3 mg/dL外,D-dimer≥500 ng/mL、AGR<1.5μ/L、维生素B 12<100μμg/mL、CD4+T<500个/mm 3均为影响HZ患者发生PHN的独立危险因素(P<0.05)。结论老年HZ患者血清学指标D-dimer≥500 ng/mL、AGR<1.5μ/L、维生素B 12<100μμg/mL、CD4+T<500个/mm 3,易发生PHN,治疗时需予以关注。

Objective To explore the common factors of elderly patients with herpes zoster(HZ)in developing postherpetic neuralgia(PHN),in order to identify high-risk groups and timely intervention in clinical diagnosis and treatment.Methods The clinical data of 187 HZ patients from June to December 2021 admitted to the outpatient department of dermatology and venereology in the hospital were retrospectively analyzed.Among them,40 developed PHN after the first diagnosis(PIN group)and 147 did not develop PHN(no PIN group).The clinical data of the two groups of patients were statistically analyzed,and the independent risk factors that may affect the incidence of PHN were screened by single factor and multi factor analysis.Results Single factor analysis of variance showed that there were no significant differences in serum homocysteine(Hcy),neutrophil to lymphocyte ratio(NLR)and C reactive protein(CRP)between the two groups(P>0.05),while there were significant differences in serum D-dimer,albumin to globulin ratio(AGR),vitamin B 12,interleukin-6(IL-6),CD4+T,1,25-(OH)2-D 3,total bilirubin(TBIL)level(P<0.05).The binary logistic regression analysis showed that D-dimer≥500 ng/mL,AGR<1.5μg/L,vitamin B 12<100μg/mL,and CD4+T<500 cells/mm 3 were all independent risk factors affecting the development of PHN in HZ patients,except for IL-6≥7 pg/mL,1,25-(OH)2-D 3<30 ng/mL,TBIL≥1.3 mg/dL(P<0.05).Conclusion Elderly HZ patients with serological indexes D-dimer≥500 ng/mL,AGR<1.5μg/L,vitamin B 12<100μμg/mL,CD4+T<500 cells/mm 3,are prone to occur PHN,which should be paid attention to during treatment.