摘要
目的:探讨糖尿病(diabetes mellitus,DM)对带状疱疹(herpes zoster,HZ)病人预后的影响。方法:纳入2018年8月至2019年8月于我院治疗的90例胸段HZ病人,根据病人是否患有DM分为D组(糖尿病组)及N组(非糖尿病组),每组45例。两组均给予相同的药物及物理治疗,比较两组之间带状疱疹后神经痛(postherpetic neuralgia,PHN)的发生率、疱疹皮损持续时间及治疗前后疼痛数字评分法(numerical rating scale,NRS)评分和阿森斯失眠量表(Athens insomnia scale,AIS)评分,同时记录补救镇痛例数及不良事件发生总例数;采用Logistic回归分析确定HZ病人预后情况的影响因素。结果:与N组相比,D组在发疹时间、住院天数、皮疹愈合时间、高血压、PHN发生率以及NRS及AIS评分上存在统计学差异(P<0.05);病人预后的Logistic分析显示,合并DM的HZ病人发生PHN的风险较非DM高4.52倍(OR=4.52,95%CI:1.05-19.43)。年龄、性别、初始疼痛以及皮疹愈合时间也与预后有明显的关系。D组住院期间补救药物例数及不良反应总例数较N组明显增多(P<0.05)。结论:DM、年龄、性别、初始疼痛以及皮疹愈合时间是HZ病人发展为PHN的重要危险因素;合并DM的HZ病人在疼痛、睡眠质量等临床症状方面更加严重,并且应用更多的镇痛药物及发生更多的不良反应。
Objective:To investigate the relationship between diabetes mellitus(DM)and prognosis of herpes zoster(HZ).Methods:Ninety cases of HZ patients hospitalized in our department from August 2018 to August 2019 were divided into group D(diabetes group)and group N(non-diabetes group)according to whether they had diabetes,with 45 patients in each group.The incidence of postherpetic neuralgia(PHN),duration of herpes lesions,Numerical rating scale(NRS),and Athens insomnia scale(AIS)before and after treatment were compared between the two groups,which were given same drugs and physical treatment.Meanwhile,the number of remedial analgesic cases and the total number of adverse events were recorded during treatment.Logistic regression analysis was used to determine the factors affecting the prognosis of patients with HZ.Results:Compared with the group N,the group D had statistical differences in eruption time,hospitalization days,rash healing time,hypertension,PHN incidence rate,and the scores of NRS and AIS(P<0.05).Logistic regression analysis of the prognosis showed that the risk of poor prognosis in HZ patients complicated with DM was 4.52 times higher than that in non-DM patients(OR=4.52,95%CI:1.05-19.43).Besides,age,sex,initial pain and healing time were significantly associated with an increased risk of poor diagnosis.The number of cases using remedial drug and the total number of adverse reactions in the group D were significantly higher than those in the group N(P<0.05).Conclusion:Diabetes mellitus,age,sex,initial pain and healing time are important risk factors for HZ patients to develop PHN.Herpes zoster patients complicated with diabetes have severer clinical symptoms in pain and sleep,which increases the application of analgesics and side effects.
作者
吴征元
杜佳溪
孙悦
季云晶
李胜男
王溢文
申文
WU Zheng-Yuan;DU Jia-Xi;SUN Yue;JING Yun-Jing;LI Sheng-Nan;WANG Yi-Wen;SHEN Wen(The Key Laboratory of Anesthesiology,Xuzhou Medical University,Xuzhou 221004,China;Department of Dermatology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China;Department of Pain Management,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China)
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2021年第4期262-268,共7页
Chinese Journal of Pain Medicine
基金
国家自然科学基金面上项目(81571066)。
关键词
带状疱疹
糖尿病
危险因素
预后
Herpes zoster
Diabetes mellitus
Risk-factors
Prognosis
