摘要
目的:探索早期干预带状疱疹(HZ)患者发生带状疱疹后神经痛(PHN)的高危因素,并建立预测模型,旨在为高危患者制定更完善的治疗方案提供线索。方法:采用前瞻性研究方法,收集2021年7月至2022年3月初次就诊于新疆医科大学第一附属医院疼痛科的HZ患者50例,男23例,女27例,年龄33~87岁,病程4~80 d。患者均行脉冲射频术治疗(温度42 ℃,脉冲频率为2 Hz,脉冲宽度20 ms,输出电压45 V,持续时间为120 s),电话或门诊随访至病程3个月时,根据是否发生PHN分为两组。分析两组患者临床资料的差异,采用单因素分析及多因素logistics回归分析筛选影响PHN发生的高危因素并建立预测模型。结果:50例HZ患者,根据是否发生PHN分为PHN组(24例)和非PHN组(26例)。单因素分析显示PHN组和非PHN组,年龄、疾病病程、皮疹面积分别为[(68±10)岁比(59±10)岁,30(30,60)d比20(12,30)d,4(2,6)%比2(1,4)%],差异均有统计学意义( P均<0.05),而性别、急性疼痛VAS评分、是否有糖尿病、25-羟维生素D水平、血沉水平、C-反应蛋白差异均无统计学意义( P均>0.05)。多因素logistics回归分析显示年龄( OR=1.099,95 CI:1.004~1.204, P=0.041)和皮疹面积( OR=1.528,95 CI:1.023~2.282, P=0.038)均是早期干预后HZ患者发生PHN的危险因素。联合年龄与皮疹面积建立预测模型,ROC曲线下面积(AUC)为0.8165,此模型的诊断价值较好。 结论:年龄大与皮疹面积大均为早期脉冲射频干预HZ患者后PHN发生的高危因素,临床上可联合这两个指标早期识别高危患者并制定更为完善的治疗方案以减少PHN的发生。
Objective To explore the high risk factors for postherpetic neuralgia(PHN)after early intervention in patients with herpetic zoster and establish a predictive model to provide clues for high-risk patients and develop a more complete treatment plan.Methods Fifty herpetic zoster patients were divided into two groups according to whether PHN occurred or not,23 males and 27 females,aged 33 to 87 years,and course of disease 4 to 80 days,from July 2021 to March 2022 in the Painology Department of the First Affiliated Hospital of Xinjiang Medical University.All patients were treated with pulsed radiofrequency at a temperature of 42℃,pulse frequency 2 Hz,width 20 ms,output voltage 45 V,and duration 120 s,and were followed up by phone or outpatient until the disease course was 3 months.Patients were divided into two groups based on whether PHN had occurred.The clinical data between the two groups were analyzed,high-risk factors for occurrence of PHN were screen by univariate analysis and multivariate logistics regression analysis,and a predictive model was established.Results In the 50 patients,24 patients suffered PHN(PHN group)and 26 patients did not suffer the PHN(non-PHN group).Univariate analysis showed that age,disease course,and rash area in PHN group and non-PHN groups were[(68±10)vs.(59±10)]years,[30(30,60)vs.20(12,30)]days,[4(2,6)%vs.2(1,4)%]respectively(all P<0.05),and there were no significant differences in gender,acute pain VAS score,presence or absence of diabetes,25-hydroxyvitamin D level,erythrocyte sedimentation rate level,and C-reactive protein level(all P>0.05).Multivariate regression analysis showed that age(OR=1.099,95 CI:1.004-1.204,P=0.041)and rash area(OR=1.528,95 CI:1.023-2.282,P=0.038)were risk factors for PHN.Combined with age and rash area,the prediction model was established,and the area under the ROC curve(AUC)was 0.8165,which had a good diagnostic value.Conclusion Older age and large lesion area are high-risk factors for the occurrence of PHN after early pulsed radiofrequency interventi
作者
廖萌萌
李亦梅
席鹏
刘磊
韩娜
布祖克拉·阿不都艾尼
Liao Mengmeng;Li Yimei;Xi Peng;Liu Lei;Han Na;Buzukela Abuduaini(Department of Painology,First Affiliated Hospital of Xinjiang Medical University,Urumqi City,Xinjiang Uygur Autonomous Region 830054,China;Department of Critical Care Medicine,First Affiliated Hospital of Xinjiang Medical University,Urumqi City,Xinjiang Uygur Autonomous Region 830054,China)
出处
《中华疼痛学杂志》
2023年第2期236-241,共6页
Chinese Journal Of Painology
关键词
带状疱疹
神经痛
带状疱疹后
脉冲射频
高危因素
预测
Herpetic zoster
Neuralgia,postherpetic
Pulsed Radiofrequency
Risk factors
Predictive model
