带状疱疹455例临床分析

目的分析带状疱疹发病年龄、平均住院日、神经痛与皮疹出现的先后顺序、其临床类型、并发症、误诊情况、发病季节及后遗神经痛的关系。方法对1999~2004年455例带状疱疹住院患者进行临床分析。结果带状疱疹平均发病年龄51岁,平均住院13天,先出现神经痛者198例(43.52%),临床类型:普通型368例(80.88%),特殊型87例(19.12%),带状疱疹并发肿瘤9例(1.98%),并发皮肤细菌感染者34例(7.47%);带状疱疹发病早期误诊65例(14.29%);后遗神经痛发生56例(17.18%),发病季节无明显差异。结论带状疱疹发病男性多于女性,60岁以上患者易发生后遗神经痛。     

建立和验证带状疱疹患者后遗神经痛风险因素预测模型

目的:探索建立带状疱疹后遗神经痛(PHN)风险因素预测模型，并进行PHN高危因素分析。方法:回顾性分析了2017年3月至2021年12月本院收住院治疗的急性期带状疱疹患者，根据是否发生PHN将其分为两组。使用LASSO联合Logistic回归分析建立预测模型，并进行危险因素评价。结果:共有307例患者入选本研究，101例(32.8%)患者出现了PHN。应用LASSO联合Logistic回归分析筛选出以下独立危险因素：年龄≥50岁(OR值3.522, 95%CI1.631～7.606,P=0.001)、合并糖尿病史(OR值2.182,95%CI 1.073～4.438,P=0.031)、急性期皮损面积≥5%(OR值2.756,95%CI 1.426～5.327,P=0.003)、先驱痛(OR值2.233,95%CI 1.216～4.099,P=0.010)、急性期疼痛程度评分(NRS)≥6分(OR值10.724,95%CI 5.549～20.725,P<0.001)。结论:年龄≥50岁、合并糖尿病史、急性期皮损面积≥5%、急性期先驱痛、急性期疼痛程度评分(NRS)≥6分为PHN发生...     

88例中老年头面部带状疱疹患者的临床观察和护理

<正>头面部带状疱疹(HZ)受累的颅神经有三叉神经、面神经、听神经,如治疗护理不当,常产生较严重的眼、面、耳部并发症。我科对88例中老年头面部带状疱疹患者进行护理取得满意疗效,现报道如下。1资料与方法1.1发病年龄2013年3月至2014年12月收治住院中老年头面部带状疱疹88例,其中男48例,女40例,年龄37~87岁,平均61.2岁,50岁13例,50~70岁53例,70岁22例。     

带状疱疹后遗神经痛相关危险因素分析

目的：明确带状疱疹后遗神经痛(postherpetic neuralgia,PHN)的危险因素。方法：分析潍坊医学院附属医院2017年9月至2019年2月带状疱疹住院患者的临床资料,依据发病后1个月是否有PHN,分为病例组和对照组。对两组患者进行单因素及多元logistic回归分析。结果：共筛选出513例患者,其中111例发生PHN（21.6%）。单因素分析示年龄、吸烟史、部位、皮疹面积、临床分型、前驱症状、早期治疗时间、使用糖皮质激素、糖尿病与PHN的发生有关。多因素Logistic回归分析结果显示,PHN的危险因素有年龄≥60岁、有吸烟史、发病诱因为精神/焦虑、初始治疗时间＞7天、急性期重度疼痛和糖尿病史(OR=6.013、3.391、6.800、22.071、21.996、3.163, 95％CI：1.694～21.341、1.219～9.436、1.310～35.296、4.049～120.314、2.864～168.946、1.281～7.811,均P＜0.05)。结论：年龄＞60岁、有吸烟史、发病诱因为精神/焦虑、早期治疗时间＞7天、重度急性期疼痛、糖尿病是PHN发生的危险因素。     

成人带状疱疹住院患者临床特点分析

目的探究带状疱疹患者的年龄、性别、发病部位、发病时皮疹及疼痛的临床特点及治疗情况。方法回顾性分析带状疱疹住院患者246例的临床资料。结果带状疱疹住院患者中以50~70岁者居多,初发年龄是(61.3±13.1)岁,女性患者较男性略高;41.1%的患者发生于头颈部,发生于头面部的患者中30.7%发生结膜炎;皮损分型79%为经典型,疼痛以中重度疼痛为主,疼痛程度在男女及部位之间差异无统计学意义,而50岁以上患者较年轻患者更易发生中重度疼痛。78%患者应用了中西医结合的治疗方法。结论带状疱疹在中老年人中住院率较高;患者的发病年龄、性别、部位、皮疹表现、疼痛状况、平均住院日等基本上与国外报道的基本一致;发生于头面部的患者住院率高,结膜炎是常见的并发症。     

50岁及以上梅毒患者176例临床特征及其危险因素分析

目的了解50岁及以上梅毒患者临床特征,探讨其相关危险因素。方法回顾性分析2015年1月-2017年1月本院确诊的176例年龄≥50岁梅毒患者的临床资料,并将本院230例非梅毒患者列为对照组,分别进行问卷调查,对梅毒感染相关危险因素进行单因素和多因素Logistic回归分析。结果 176例梅毒患者中,男102例(57.95%),女74例(42.04%)。以50~69岁最多(136例,占77.27%);初中及以下文化程度140例,占79.55%;职业分布以农民/民工(42例,占23.86%)和工人/退休工人(61例,占34.66%)为主。潜伏梅毒143例,占81.25%,且103例(58.52%)是因术前检查及住院筛查而首次就诊。Logistic多因素分析显示:非婚性行为、安全套使用情况、对嫖娼的态度及梅毒知晓情况是梅毒感染的主要危险因素。结论加强婚内性道德、性观念的健康教育,降低非婚性行为发生率,推广安全套使用,提高该人群梅毒知识知晓率,是目前预防和控制50岁及以上人群梅毒感染的重要措施。     

HIV/AIDS合并带状疱疹患者临床特征及发病相关因素分析

目的 探讨HIV/AIDS合并带状疱疹患者的临床特征及发病相关危险因素。方法 整群抽取2019年8月-2020年1月在大理市第二人民医院艾滋病抗病毒门诊就诊的715例HIV/AIDS患者为研究对象,分为病例组245例(HIV/AIDS合并带状疱疹患者)和对照组470例(无带状疱疹的HIV/AIDS患者),并以同期住院的146例HIV阴性带状疱疹患者为非HIV组。采集患者临床资料,用SPSS22.0软件进行统计分析。结果 HIV/AIDS患者带状疱疹发生率为34.27%,复发率为11.43%,重型带状疱疹发生率高。病例组患者平均年龄45.9岁,显著低于非HIV组带状疱疹患者。病例组平均CD4⁺T淋巴细胞为219个/μL,显著低于对照组403个/μL。HIV/AIDS患者发生第1次、第2次和第3次带状疱疹平均CD4⁺T淋巴细胞计数分别为268个/μL、143个/μL和50个/μL。低CD4⁺T淋巴细胞计数、合并病毒性肝炎为HIV/AIDS患者发生带状疱疹的危险因素,接受ART治疗为保护因素。结论 HIV/AIDS患者带状疱疹...     

宫颈癌、卵巢癌患者梅毒螺旋体感染情况分析

目的:分析并探讨妇科恶性肿瘤宫颈癌、卵巢癌的发生与感染梅毒螺旋体的关系。方法:选取2005年1月至2015年5月期间来我院接受治疗的妇科恶性肿瘤宫颈癌658例、卵巢癌246例,检测肿瘤患者梅毒螺旋体感染情况,分析妇科肿瘤宫颈癌和卵巢癌对梅毒螺旋体感染的发生影响。结果:658例宫颈癌患者中合并梅毒螺旋体感染患者68例(10.33%),246例卵巢癌患者合并梅毒螺旋体感染患者4例(1.63%)。宫颈癌合并梅毒螺旋体感染率明显高于卵巢癌(P0.05)。病理类型分析结果显示,鳞癌患者594例,其中梅毒感染者68例,而腺癌56例、腺鳞癌8例患者中均无梅毒感染者;Ⅰ期肿瘤患者354例,梅毒感染58例;Ⅱ期304例,梅毒感染10例。年龄分析结果显示,30~39岁136例,梅毒感染32例(23.53%);40~49岁170例,梅毒感染30例(17.65%);年龄50~59岁258例,梅毒感染6例(2.33%);年龄60岁以上94例,梅毒感染0例。教育水平结果显示,高中及高中以上264例,梅毒感染6例(2.27%);高中以下394例,梅毒感染62例(15.74%)。结论:宫颈癌患者梅毒螺旋体感染率明显高于卵巢癌患者,且与年龄、教育水平和病理类型、病理分期相关,为临床防治提供理论支持。     

300例带状疱疹临床分析

我科从1989年11月～1998年11月共收治带状疱疹300例,现报告如下。临床资料　300例均为住院患者。男184例,女116例,男:女为1.6:1。年龄13～82岁,其中13～20岁5例(1.67%),21～30岁28例(9.33%),31～40岁32例(10.67%),41～50岁43例(14.33%),51～60岁90例(30.00%),61～70岁93例(31.00),71～82岁9例(3.00%)。51岁以上共计192例(64.00%)。180例发病前有感冒史,12例ＳＬＥ用激素治疗过程中出现,6例恶性肿瘤,4例系术后化疗期间发生,糖尿病9例。发病时间:1～12月发病例数分别为14、38、36、26、26、21、26、18、17、42、24、22例。皮损部位见表1,皮损…     

带状疱疹后遗神经痛的危险因素分析

目的 评估带状疱疹患者发生后遗神经痛(postherpetic neuralgia,PHN)的相关风险因素.方法 收集安徽医科大学第一附属医院皮肤性病科2017年1月至2018年1月间确诊的带状疱疹住院患者256例,采用问卷调查及电话等随访方式,综合评估患者发病年龄、性别等因素与PHN的关联性.结果 256例患者最终随...     

A retrospective study of the clinical presentation and outcome of herpes zoster in a tertiary dermatology outpatient referral clinic

Background This is a retrospective study of the epidemiology and morbidity of herpes zoster and the risk factors for herpes zoster morbidity in Singapore. Results The mean age of 164 patients with herpes zoster seen at our dermatology clinic between January 1994 and December 1995 was 48.8 years, with a sex ratio of 1: 1. The common presenting symptoms were pain (90%), feelings of helplessness and depression (20%), and flu-like symptoms (12%). The commonest prodromes were pain (41%), itching (27%), and paresthesia (12%). Prodromal pain was more frequently experienced by patients aged more than 50 years (42%) than by patients aged less than 30 years (25%). The thoracic (45%) and cervical (23%) dermatomes were the most commonly affected in all age groups. There was no statistically significant difference in the frequency of dermatomal distribution among the different age groups and between the sexes. Pain was experienced by almost all (95%) patients during the course of their disease. It tended to be more severe in older patients. Burning (26%), stabbing (15%), and shooting (15%) pain were the most common types experienced. Post-herpetic neuralgia was significantly more common in older patients. The prevalence of post-herpetic neuralgia decreased over time in all age groups. A higher proportion of older patients (more than 50 years of age) (20%) suffered from post-herpetic neuralgia compared with younger patients (less than 30 years of age) (7%) (not significant). Patients in all age groups considered acute pain (46%) and persistent pain (25%) to be their most unbearable symptoms during the course of herpes zoster. The most significant problems caused by herpes zoster pain were insomnia (25%), misery (feeling helpless and depressed) (20%), limitation of movement (9%), and inability to continue work (8%). Insomnia was significantly more commonly experienced by patients more than 50 years of age (36%) than those less than 30 years of age (P= 0.026). Few patients (9%) consulted their general practitioner (GP) during the prodrome or on the day of appearance of skin eruptions. Most patients (45%) consulted their GP within the first 3 days of the onset of skin eruptions; 33% sought treatment more than 3 days after the appearance of zoster symptoms. Only 30% of patients were willing to pay more than $200 for antiviral therapy. Most (43%) were only prepared to pay for antiviral treatment if it cost less than $200. The most Important features the patients wished to derive from antiviral therapy were a shortening of the duration of skin lesions (55%) and a reduction in the severity of pain (acute and chronic) (30%). Conclusions Our study indicated that older patients (aged more than 50 years) were at a higher risk of developing post-herpetic neuralgia. They were also more likely to suffer morbidity, e.g. insomnia. There is a need to educate patients at risk to identify the prodrome and skin eruptions of herpes zoster so that early antiviral therapy can be considered.     

肾科高龄病人伴发带状疱疹37例

目的:了解肾科高龄病人伴发带状疱疹的情况及临床特点。方法:对37例并发带状疱疹的老年肾科住院病人进行回顾性研究。结果:带状疱疹是老年肾科住院病人最常见并发症。病程长,血疱、坏死等皮疹及神经痛后遗症较多见。结论:老年肾科住院病人并发带状疱疹发生率高,临床表现有其特点。     

Herpes zoster and the stage and prognosis of HIV-1 infection.

OBJECTIVES: To examine the incidence of herpes zoster in HIV-1 infection. To assess the prognostic significance of the occurrence of herpes zoster and progression to AIDS or death DESIGN AND METHODS: 146 homosexually active men with known times of HIV-1 seroconversion were identified through the Sydney AIDS Prospective Study and the clinic records of a private medical practice with large caseload of HIV infected homosexual men. Medical records were reviewed for a history of herpes zoster, CD4+ lymphocyte counts, and HIV-1 disease status. Cox's proportional hazards model was used to determine whether herpes zoster predicted progression to AIDS or death. RESULTS: After a mean follow up of 54 months, 30 men (20%) had an episode of herpes zoster and three of these men had one recurrence. The overall incidence of herpes zoster was 44.4 episodes per 1000 person years (95% CI 30.0-63.5). Herpes zoster was not found to be a marker of deteriorating immune functions as measured by CD4+ lymphocyte counts. CD4+ counts did not differ significantly between those with and without zoster at 1 year (551 v 572.10(6)/1, p = 0.79), 2 years (451 v 557, p = 0.11), and 3 years (424 v 481, p = 0.50) following HIV-1 seroconversion. There was no statistically significant difference in progression to AIDS (RR = 1.89, 95% CI 0.80-4.46, p = 0.15) or death (RR = 0.90, 95% CI 0.31-2.65, p = 0.85) from HIV-1 sero-conversion in those who did and those who did not develop herpes zoster. CONCLUSION: The incidence of herpes zoster was consistent with the findings of other studies. There was no association between the occurrence of herpes zoster and progression of HIV-1 disease.     

Disseminated Varicella Zoster Virus in an Immunized Child as the Acquired Immunodeficiency Syndrome‐defining Illness

Abstract: Varicella zoster virus (VZV) immunization aids in the prevention of future VZV infections in immunocompetent patients; however, severely immunocompromised patients remain at increased risk of VZV infection. We report a case of a 10‐year‐old boy previously immunized to Varicella who presented with herpes zoster with hematogenous dissemination as the Acquired Immunodeficiency Syndrome‐defining illness. Disseminated VZV is more commonly seen in human immunodeficiency virus (HIV)‐infected individuals with more advanced disease, as was the case with our patient. Disseminated VZV infection in a previously immunized child should raise suspicion for underlying immunosuppression.     

儿童带状疱疹临床特征分析

目的探讨儿童带状疱疹的临床特征,为本病的临床诊治提供参考依据。方法回顾性分析2012年1月—2015年12月在皮肤科就诊的80例带状疱疹患儿的临床资料。结果 80例带状疱疹患儿年龄6个月~14岁,多数患儿无免疫功能抑制证据,11例患儿既往有哮喘病史。多发于高温季节。受累部位依次是胸背部(38例)、腰腹部(25例)、四肢(11例)和头面部(6例)。患儿对症支持治疗反应良好,平均病程(10.77±1.99)d,无严重并发症。结论儿童带状疱疹多为良性病程,无进行性不适症状。     

婴幼儿带状疱疹三例并文献复习

目的:分析婴幼儿带状疱疹的临床特点.方法:报道3例婴幼儿带状疱疹病例并对近10年文献报道病例进行回顾性分析.结果:共分析26例患儿,年龄74天～3岁,其中≤6个月患儿8例(30.8％);孕期或产后感染及接触VZV史12例(50％);患儿感染或接触VZV史7例(31.8％);伴有上呼吸道感染症状15例(60％);皮疹与成...     

Disseminated herpes zoster

Eleven case of disseminated herpes zoster (DHZ) who were hospitalised in the Dermatovenereology ward from January 1992 to April 1995 were selected for this study. All had classical herpes zoster (HZ) but within another 2 to 15 days had developed aberrant vesicles on the trunk, limbs and face. None of them had serious associated immunosuppressive disorder or malignancy. However, 3 cases had diabetes mellitus, 2 were receiving prednisolone 15 mg daily for the last few days, 2 had anaemia and deficiencies and 1 had a urinary tract infection. Only one patient needed oral acyclovir therapy. All were cured without any sequelae.     

播散性带状疱疹53例临床特点分析

目的 探讨播散性带状疱疹的诱因、临床特点及带状疱疹后遗神经痛的影响因素。方法 对2012-2015年收治的53例播散性带状疱疹患者和809例普通带状疱疹患者的临床资料进行回顾性分析,采用logistic回归模型分析播散性带状疱疹的发生、疼痛程度、带状疱疹后遗神经痛的影响因素。结果 播散性带状疱疹患者年龄（56.66 ± 17.24）岁,普通带状疱疹患者组（56.50 ± 15.51）岁,两组差异无统计学意义（t = 0.071,P > 0.05）,但两组性别分布差异有统计学意义（χ2 = 8.16,P = 0.004）。播散性带状疱疹组出现大疱（15.09%）、脓疱（47.17%）、发热（30.19%）的比例显著高于普通带状疱疹组（3.58%、26.82%、8.03%）,差异均有统计学意义（χ2 = 16.04、10.20、28.68,均P < 0.01）。播散性带状疱疹组入院时疼痛评分中位数（P25 ~ P75）为6（4 ~ 7.5）分,也高于普通带状疱疹组［5（3 ~ 7）分］,差异有统计学意义（Z = -3.460,P = 0.001）。Logistic回归分析显示,性别、年龄、劳累、HIV感染与带状疱疹皮疹播散有关（P < 0.05）,尤其是HIV感染（OR = 5.570,95% CI：1.196 ~ 25.939,P = 0.029）、性别（OR = 0.166,95% CI：0.029 ~ 0.945,P = 0.043）、年龄（OR = 1.064,95% CI：1.010 ~ 1.119,P = 0.019）及抗病毒治疗天数（OR = 0.669,95% CI：0.505 ~ 0.885,P = 0.005）是带状疱疹后遗神经痛的影响因素。结论 男性、老年、劳累、HIV感染是皮疹播散的影响因素,尤其是HIV感染是播散性带状疱疹的高危因素。男性、老年及抗病毒治疗天数是带状疱疹后遗神经痛的相关因素。