50岁以上带状疱疹患者后遗神经痛的影响因素及其防治  

The Influencing Factors and Prevention of Postherpetic Neuralgia of Patient with Herpes Zoster over 50 Years Old

作　　者：徐武生[1] 于建斌[1] 罗杨[1] 宋飞娟 黄云慧 

机构地区：[1]郑州大学第一附属医院皮肤科,河南郑州450052

出　　处：《中国皮肤性病学杂志》2014年第12期1260-1261,1272,共3页The Chinese Journal of Dermatovenereology

基　　金：郑州大学研究生科学研究项目

摘　　要：目的探讨50岁以上带状疱疹患者带状疱疹后遗神经痛(PHN)的影响因素及防治。方法收集本科2012年11月-2013年5月共88例50岁以上住院带状疱疹患者详细信息,定义PHN为疱疹消退后疼痛持续3个月以上。将年龄、性别、初发部位、皮损面积、疼痛程度、初期抗病毒治疗时间及疗程、是否合用小剂量糖皮质激素等列为自变量,建立Logistic回归模型,利用向前逐步法筛选出有统计学意义的变量。结果 Logistic回归分析结果显示:年龄(P=0.003,B=2.096)、起病时疼痛程度(P=0.010,B=2.011)及合并症(P=0.041,B=1.643)为PHN的危险因素;抗病毒治疗(P=0.043,B=-2.423)、营养神经及止痛治疗(P=0.032,B=-2.279)和合用小剂量糖皮质激素(P=0.054,B=-2.196)为保护因素。结论对50岁以上带状疱疹患者,尤其是初期疼痛剧烈或伴有其他内科疾病者应早期接受抗病毒、营养神经及止痛治疗,如无禁忌合用小剂量糖皮质激素可减少PHN的发生。Objective To discuss the risk factor and prevention of postherpetic neuralgia of patient with herpes zoster over 50 years old. Methods Eighty-eight inpatients with herpes zoster over 50 years old were coUected. PHN was defined as pain persisting more than three months after rash onset. The age, gender, site of onset, acreage of onset, severity of pain, antiviral therapy, combination of small dose steroids and complications were set as independent variable and the Logistic regression model was established. Statistically significant variables were selected using stepwise method forward. Results Logistic regression analysis screened out the following factors ： age （ P = 0.003, B = 2. 096 ）, severity of pain （ P = 0.010, B = 2.011 ）, antiviral therapy （ P = 0. 043, B = - 2. 423 ）, combination of small dose steroids （P = 0.054, B = - 2. 196 ）, complications （ P = 0. 041, B = 1. 643 ） , neurotrophic and analgetic treatment（ P = 0. 032, B = - 2. 279 ）. The age, severity of pain and complications were risk factors. The early antiviral therapy, neurotrophic and analgetic treatment and combination of small dose steroids were protective factors. Conclusion Early antiviral, neurotrophic and analgetic therapy should be given for patients over 50 years old, especially for those early drastic pain or other complications were accompanied. Small dosage of steroids was recommended if without contraindication.

关 键 词：带状疱疹 带状疱疹后遗神经痛 影响因素 防治 

分 类 号：R752.11[医药卫生—皮肤病学与性病学]