带状疱疹并发肾功能不全的危险因素分析及预测模型构建  

Analysis of risk factors and construction of a prediction model for herpes zoster complicated by kidney dysfunction

作　　者：章甜 任中杰[1] 陈仲汉 李莹 边可[2] Zhang Tian;Ren Zhongjie;Chen Zhonghan;Li Ying;Bian Ke(Department of Nephrology,Hangzhou Third People's Hospital,Hangzhou310009,Zhejiang Province,China)

机构地区：[1]杭州市第三人民医院肾脏内科,杭州310009 [2]杭州市第三人民医院皮肤科,杭州310009

出　　处：《中国基层医药》2025年第1期100-105,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨带状疱疹并发肾功能不全的危险因素及其预测模型构建。方法回顾性分析杭州市第三人民医院2022年1月至2023年12月收治的150例带状疱疹患者的临床资料,按是否并发肾功能不全分为肾功能不全组(30例,并发肾功能不全)及对照组(120例,未并发肾功能不全),分析带状疱疹并发肾功能不全的影响因素,构建logistic预测模型,通过受试者工作特征(ROC)曲线评价该模型预测带状疱疹并发肾功能不全的价值。结果两组患者性别、身体质量指数、合并症(高血压、高脂血症)、发病部位等差异均无统计学意义(均P>0.05);肾功能不全组年龄(67.74±6.71)岁,大于对照组的(62.32±5.58)岁(t=4.56,P<0.001);肾功能不全组合并糖尿病、重度疼痛程度、皮损面积大、大剂量使用抗病毒药物、血红蛋白<120 g/L等分别为46.67%(14/30)、63.33%(19/30)、56.67%(17/30)、46.67%(14/30)、40.00%(12/30),均高于对照组的14.17%(17/120)、34.17%(41/120)、31.67%(36/120)、19.17%(23/120)、10.00%(12/120)(χ^(2)=15.46、2.60、2.10、9.76、16.07,P<0.001、0.002、0.035、0.002、<0.001)。logistic分析显示,年龄大(OR=3.023)、合并糖尿病(OR=4.315)、重度疼痛程度(OR=3.623)、皮损面积大(OR=3.481)、大剂量使用抗病毒药物(OR=4.030)、血红蛋白<120 g/L(OR=0.151)等均为带状疱疹并发肾功能不全的危险因素(均P<0.05)。根据影响因素构建logistic预测模型为:Logit(P)=-8.753+1.106×年龄+1.462×糖尿病+1.287×疼痛程度+1.247×皮损面积+1.394×大剂量使用抗病毒药物+(-1.889)×血红蛋白。ROC曲线显示,其预测带状疱疹并发肾功能不全的曲线下面积(AUC)为0.904[95%CI(0.859,0.937)],预测敏感度、特异度分别为84.62%、89.04%。结论带状疱疹并发肾功能不全的危险因素包括年龄大、合并糖尿病、疼痛程度重、皮损面积大、大量使用抗病毒药物、血红蛋白<120 g/L等,根据上述因素构建logistic预测模型能为临床预测肾�ObjectiveTo analyze the risk factors for herpes zoster complicated by kidney dysfunction and construct a prediction model.MethodsA retrospective analysis was conducted on the clinical data of 150 patients with herpes zoster who were admitted to Hangzhou Third People's Hospital from January 2022 to December 2023.The patients were divided into two groups based on the presence of kidney dysfunction:kidney dysfunction group(n=30,with kidney dysfunction)and control group(n=120,without kidney dysfunction).The risk factors for herpes zoster complicated by kidney dysfunction were analyzed.The logistic prediction model was constructed.The effectiveness of this prediction model in predicting herpes zoster complicated by kidney dysfunction was assessed using the receiver operating characteristic curve.ResultsThe differences in gender,body mass index,comorbidities(hypertension and hyperlipidemia),and sites of onset between the two patient groups were not statistically significant(all P>0.05).The average age of the kidney dysfunction group was(67.74±6.71)years,which was significantly older than that in the control group[(62.32±5.58)years,t=4.56,P<0.001].In the kidney dysfunction group,the proportions of patients with comorbid diabetes,severe pain,large lesion area,high-dose antiviral medication use,and hemoglobin levels<120 g/L were 46.67%(14/30),63.33%(19/30),56.67%(17/30),46.67%(14/30),and 40.00%(12/30),respectively.These values were all significantly greater than those in the control group[14.17%(17/120),34.17%(41/120),31.67%(36/120),19.17%(23/120),and 10.00%(12/120),χ^(2)=15.46,2.60,2.10,9.76,16.07,P<0.001,0.002,0.035,0.002,<0.001).Logistic regression analysis revealed that older age(OR=3.023),comorbid diabetes(OR=4.315),severe pain(OR=3.623),large lesion area(OR=3.481),high-dose antiviral medication use(OR=4.030),and hemoglobin levels<120 g/L(OR=0.151)were all significant risk factors for herpes zoster complicated by kidney dysfunction(all P<0.05).Based on these risk factors,the following logistic prediction model was

关 键 词：带状疱疹 肾功能不全 危险因素 预测 LOGISTIC模型 年龄因素 药物相关性副作用和不良反应 

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