恶性淋巴瘤患者继发带状疱疹的危险因素分析  

Risk factors for secondary herpes zoster in patients with malignant lymphoma

作　　者：马泳泳[1] 刘慧[2] 陈枫煜[2] 周淑娟[1] 沈志坚[1] 钱红兰[1] 蔡芳芳[1] 俞康[1] 

机构地区：[1]温州医科大学附属第一医院血液科,浙江温州325000 [2]温州医科大学第一临床学院,浙江温州325000

出　　处：《中华医院感染学杂志》2014年第17期4266-4268,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生研究基金项目(2014KYA132);温州市科技计划基金资助项目(Y20140072)

摘　　要：目的探讨恶性淋巴瘤患者化疗后继发带状疱疹的危险因素,指导临床预防与控制医院感染的发生。方法选取2002年1月-2012年10月血液科住院的123例恶性淋巴瘤患者,其中发生带状疱疹患者51例作为病例组,无带状疱疹的患者72例,作为对照组,采用病例对照研究方法对恶性淋巴瘤后带状疱疹患者进行分析,先将研究变量做单因素分析,再将有意义的变量进行多因素非条件logistic同归分析。结果带状疱疹患者的发病部位以胸肋神经区和腰腹神经区为主,分别占56.86%和27.45%;带状疱疹患者的临床类型以寻常型为主,占86.27%;单因素分析显示,Ann Arbor分期(Ⅲ、Ⅳ期)、B症状、初诊时原因不明的发热(>38℃)、恶性淋巴瘤未缓解状态与恶性淋巴瘤患者带状疱疹发病显著相关(P<0.01),而恶性淋巴瘤达缓解状态是具有统计学意义的保护因素(P<0.01);进一步行多因素logistic回归分析,恶性淋巴瘤达缓解状态(OR=0.091)、Ann Arbor分期(Ⅰ、Ⅱ期)(OR=0.089)、A症状(OR=0.065)与恶性淋巴瘤患者带状疱疹发病呈负相关(P<0.05)。结论医师应关注恶性淋巴瘤患者发生带状疱疹的危险因素,早期给予积极治疗。OBJECTIVE To explore the risk factors for secondary herpes zoster in the malignant lymphoma patients undergoing chemotherapy so as to provide guidance for clinical prevention and control of nosocomial infections. METHODS A total of 123 patients with malignant lymphoma who were hospitalized the department of hematology from Jan 2002 to Oct 2012, were recruited in the study, then 51 patients complicated with herpes zoster were assigned as the case group, 72 patient without herpes zoster were set as the control group, the case-control study was conducted for the malignant lymphoma patients with secondary herpes zoster, the univariate analysis of the study variables was firstly performed, the multivariate logistic regression analysis was then performed for the meaningful variables. RESULTS The sternocostal nerve zone and waist nerve zone were the predominant onset sites of the herpes zoster patients, accounting for 56. 860//00 and 27.45%, respectively. The common clinical manifestations were dominant among the patients with herpes zoster, accounting for 86. 27%. The univariate analysis showed that the Ann Arbor classification （stage Ⅲ/Ⅳ）, symptom B, unknown cause of fever （more than 38℃） as the primary diagnosis, and malignant lymphoma without remission （recurrence or PD） were associated with the herpes zoster （P〈0.01）, however, the status of remission of malignant lymphoma was the protective factor with statistical significance （P〈0.01）. Multivariate logistic regression analysis showed that the remission of malignant lymphoma （OR=0. 091）, Ann Arbor stage （stage Ⅰ and Ⅱ ） （OR= 0. 089）, and symptom A were negatively correlated with the herpes zoster （P〈0.05）. CONCLUSION It is necessary for the clinicians to pay high attention to the risk factors for herpes zoster in the patients with malignant lymphoma and conduct positive treatment in early stage.

关 键 词：恶性淋巴瘤 带状疱疹 危险因素 病例对照 研究 

分 类 号：R181.32[医药卫生—流行病学]