肾移植术后出现带状疱疹临床特征分析及影响因素研究

目的探讨肾移植术后出现带状疱疹临床特征及影响因素。方法选取2016年1月至2019年1月我院进行肾移植的719例患者作为研究对象,分析其术后发生带状疱疹情况,采用logistic回归分析确定其相关危险因素。结果719例患者中37例发生带状疱疹,发生率为5.15%,发病距肾移植手术时间为0.5~60个月,平均(4.12±2.11)个月,发生带状疱疹患者中,有36例出现皮肤改变,且分布部位以四肢所占比例最高,为35.14%,其次为胸腹部及腰背部,分别占27.03%及18.92%。有17例患者出现后遗神经痛,占其总数的45.95%。多因素logistic回归分析显示,高龄及进行激素冲击治疗为肾移植发生带状疱疹的独立危险因素(P<0.05)。结论肾移植发生带状疱疹以水痘状皮疹为主,且皮损部位主要为四肢及胸腹部,高龄及进行激素冲击治疗为肾移植发生带状疱疹的独立危险因素。加强对高龄及进行激素冲击治疗患者的观察,尤其注意观察其四肢及胸腹部皮肤是否发生破损。

Analysis of clinical characteristics and study of influence factors on herpes zoster after kidney transplantation

Objective To investigate the clinical characteristics and influence factors on herpes zoster after kidney transplantation.Methods To select 719 cases of patients who underwent kidney transplantation in our hospital from January 2016 to January 2019 as the study subjects,the postoperative herpes zoster was analyzed,and logistic regression analysis was used to determine the related risk factors.Results There were 37 cases of patients developed herpes zoster in 719 cases,the incidence rate was 5.15%,and the time from onset of kidney transplantation was 0.5 to 60 months,with an average of(4.12±2.11)months.Among the patients with herpes zoster,36 cases had changes of skin,and the distribution of the highest proportion of the limbs,was 35.14%,followed by the chest and lower back,accounting for 27.03%and 18.92%,respectively.There were 17 patients with post-herpetic neuralgia,accounting for 45.95%of the total.Multivariate logistic regression analysis showed that the elderly age and hormone shock therapy were the independent risk factors for herpes zoster after kidney transplantation(P<0.05).Conclusion The varicella-like rash was the main cause of herpes zoster after kidney transplantation,and the lesions were mainly the limbs,thorax and abdomen,and the elderly age and hormonal shock therapy were the independent risk factors for herpes zoster after kidney transplantation.Medical staff should strengthen the observation of elderly patients undergoing hormone shock therapy,especially pay attention to observe whether the skin of their limbs,chest and abdomen was damaged.