免疫低下人群伴发带状疱疹78例临床特征分析  

Clinical features of 78 cases of herpes zoster in immunocompromised populations

作　　者：潘晓媛 朱鑫宇 王飞[1] 董正邦[1] Pan Xiaoyuan;Zhu Xinyu;Wang Fei;Dong Zhengbang(Department of Dermatology,Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院皮肤科,南京210009

出　　处：《中华皮肤科杂志》2025年第3期239-244,共6页Chinese Journal of Dermatology

基　　金：东南大学附属中大医院2024年高水平学科建设项目(2024GSPKY18)。

摘　　要：目的探讨免疫低下人群伴发带状疱疹的临床特征。方法回顾东南大学附属中大医院2016年1月至2023年12月间收治的78例伴有带状疱疹的免疫低下人群患者,列为观察组,在同期住院的患有带状疱疹的免疫正常的普通患者中以年龄、入院时间1∶1匹配78例患者为对照组。比较两组患者一般资料、临床表现及实验室检查包括血常规、肝功能、肾功能、炎症指标等的差异。结果观察组男27例,女51例,年龄(65.76±14.47)岁;观察组患者免疫低下的主要原因为实体肿瘤(47例,60.26%)和血液肿瘤(7例,8.97%),26例(33.33%)因自身免疫性疾病采用泼尼松≥10 mg/d治疗超过2周。对照组男35例,女43例,年龄(67.73±13.89)岁。两组间性别、年龄、皮疹或疼痛首发至入院时间、皮损愈合时间、疼痛与皮疹的出现顺序、发病体侧及播散性带状疱疹患者占比差异均无统计学意义(P>0.05)。两组患者受累神经节段差异有统计学意义(P=0.013);观察组受累神经主要为胸臂神经(34例,43.59%),腰骶神经(29例,37.18%);对照组主要为腰骶神经(31例,39.74%)、颅颈神经(25例,32.05%)。两组皮疹形态主要为水疱、脓疱和/或血疱,观察组皮疹表现为脓疱和/或血疱的患者比例(25例,32.05%)高于对照组(11例,14.10%)(χ2=7.08,P=0.008)。观察组伴发热患者比例(24例,30.77%)、口服止痛药频次/住院时长[2.00(1.26,2.33)次/d]、复发患者比例(6例,7.69%)均高于对照组[13例,16.67%;1.43(1.00,2.00)次/d;0]。观察组组中贫血(27例,34.62%)、肾功能异常(9例,11.54%)患者比例高于对照组[6例(7.69%);2例(2.56%)],丙氨酸转氨酶/天冬氨酸转氨酶比值、红细胞沉降率、C反应蛋白升高的患者比例高于对照组,白细胞、白蛋白、前白蛋白、CD8+T细胞计数下降的患者比例高于对照组,差异均有统计学意义(均P<0.05)。观察组新型炎症指标中性粒细胞/淋巴细胞计数比值、红细胞分布宽度/血红蛋白比�Objective To investigate clinical characteristics of immunocompromised individuals with herpes zoster.Methods A retrospective study was conducted on 78 immunocompromised patients with herpes zoster hospitalized at Zhongda Hospital affiliated to Southeast University from January 2016 to December 2023,and these patients were assigned to the observation group.During the same period,78 immunocompetent inpatients with herpes zoster matched(1∶1 ratio)by age and admission time served as a control group.General data,clinical manifestations,and laboratory findings(including blood routine test,liver and kidney function,and inflammatory markers)were compared between the two groups.Results In the observation group,there were 27 males and 51 females,with the age being 65.76±14.47 years;the main causes of immunocompromise in this group were solid tumors(47 cases,60.26%)and hematologic tumors(7 cases,8.97%);26(33.33%)patients with autoimmune diseases were treated with prednisone at a dose of≥10 mg/d for more than 2 weeks.In the control group,there were 35 males and 43 females,with the age being 67.73±13.89 years.No significant differences were found between the two groups in terms of gender,age,time from the onset of rashes or pain to hospitalization,time to lesion healing,the order of appearance of pain and rashes,the affected side of the body,or the proportion of patients with disseminated herpes zoster(all P>0.05).However,there was a significant difference in the distribution of affected nerve segments between the two groups(P=0.013);the main affected nerves were the thoracic and brachial nerves(34 cases,43.59%)and the lumbosacral nerves(29 cases,37.18%)in the observation group,while the lumbosacral nerves(31 cases,39.74%)and cranial-cervical nerves(25 cases,32.05%)were more commonly affected in the control group.The skin lesions in both groups mainly manifested as blisters,pustules and/or hemorrhagic blisters,and the proportion of patients with pustules and/or hemorrhagic blisters was significantly higher in the obser

关 键 词：带状疱疹 免疫低下人群 临床特征 病例对照研究 

分 类 号：R75[医药卫生—皮肤病学与性病学]