血液透析患者合并带状疱疹的临床诊治  

Clinical data of hemodialysis patients with herpes zoster

作　　者：罗明乾[1] 贺芳 张艳霞 李慧娟 姜松青[1] 石晓峰[1] Luo Mingqian;He Fang;Zhang Yanxia;Li Huijuan;Jiang Songqing;Shi Xiaofeng(Department of Nephrology,The Central Hospital of Jiangmen City,Jiangmen 529000,China)

机构地区：[1]广东省江门市中心医院肾内科,江门529000

出　　处：《国际移植与血液净化杂志》2020年第4期15-18,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的:探讨血液透析患者合并带状疱疹的诊治特点,以期寻找针对终末期肾病合并带状疱疹患者安全和有效的治疗对策。方法:对我院2015年1月至2019年12月收治的12例血液透析合并带状疱疹患者的临床表现和治疗方法进行回顾性分析。结果:12例血液透析合并带状疱疹患者中最常见的首发临床表现为皮肤疼痛91.7%(11/12),其次为疱疹形成83.3%(10/12),斑丘疹占16.7%(2/12)。维持性血液透析患者应用阿昔洛韦后最常见的不良反应为精神症状改变(66.7%,8/12),且与用药剂量明显相关,其中大于推荐剂量组患者精神症状的发生率为100%,与小于推荐剂量组患者精神症状发生率(25%)相比差异有统计学意义(P=0.01)。结论:血液透析合并带状疱疹易于确诊,但需要严格根据肾功能减退程度选择阿昔洛韦使用剂量。Objective:To observe clinical data of herpes zoster(HZ)in patients undergoing maintenance hemodialysis for seeking a safe and effective therapeutic strategy.Methods:The clinical features and treatment methods of 12 patients undergoing maintenance hemodialysis with herpes zoster were retrospectively analyzed from January 2015 to December 2019.Results:12 patients in our blood purification center developed HZ,and they received the oral dose of acyclovir.The primary clinical manifestation was skin pain(91.7%),followed by vesicular rash(83.3%)and maculopapular or crusted rash(16.7%).The most common adverse reactions of Acyclovir were mental and neurological symptoms(6.7%).The incidence rate was 100%in the group of more oral dose,which was significantly higher than the lower dose group(25%).Conclusions:It is generally easy to diagnose HZ based on the clinical examination that shows the characteristic pain,grouped vesicular rash in a dermatomal distribution.However,the dose of Acyclovir should be reduced strictly according to the degree of renal impairment.

关 键 词：维持性血液透析 尿毒症 带状疱疹 阿昔洛韦 神经毒性 

分 类 号：R752.12[医药卫生—皮肤病学与性病学] R692.5[医药卫生—临床医学]