Clinical Analysis And Virus Genotyping Of Herpes Zoster In Kunming

[Objectives]The research is mainly to analyze the patient suffering herpes zoster in terms of the clinical characteristics like their general information,skin damage feature,pain status,curing and prognosis.The research also measures the genotyping of VZV(varicella-zoster virus)in Kunming,analyzes the correlation between the genotyping and part of the clinical variables.This research is to provide theoretical bases for the prevention and curing of herpes zoster in Kunming.[Methods]1.Collect patients' clinical information who got the hospitalization because of herpes zoster in Dermatological Department in The First Affiliated Hospital of Kunming Medical University in 2013-2015.Finally,643 patients are remained,whose medical information are given a retrospective analysis;after the analysis,a conclusion on the patients in terms of sex,age,morbidity season,the day of first visit,skin damage part,type of skin damage,pain of the skin damage,cure and prognosis etc.2.Collect blister fluid from 5 patients suffering chicken pox and 124 patients suffering herpes zoster.Then extract DNA of VZV from the blister fluid.After that,measure the gene sequence of ORF22,ORF54 and ORF38 by the method of PRC amplification and sequencing.At last,analyze the genotyping via gene pool and software DNAMAN.At the same time,the patients'information like age,sex and nationality shall be recorded while the genotyping shall be compared with VZV genotyping.[Results]1.According to the statistics about the 643 patients,it is known that the youngest patient is 5 years old while the oldest one is 93 years old.The average age is(58.7±14.6);also,it is found that herpes zoster will be highly suffered by the people when they are getting old,which will form a peak at the age of 60-70.Pursuant to the occurrence regularity,the patients suffering herpes zoster are divided into four different groups according to their ages:there are 152 patients at the age of less than 50 years old(23.64%);there are 135 patients at the age of 50-59(21.00%);there are 203 patients at the age of 60-69(31.57%)and there are 153 patients at the age of more than 70(23.79%).Besides,among the 643 patients,there are 289 male patients(44.9%)while 354 females(55.15),with a ratio of 0.82:1).Normally,herpes zoster is mainly occurred in summer and autumn.For the two groups at the age of less than 50 years old and 50-59 years old,the patients' root zone entry will be more adversely affected than the patients 60-69 years old and older than 70 years old.Meanwhile,patients who are at the age of 50-59 years old,60-69 years old and older than 70 years old will get their lower limb nerve zone more adversely affected than the patients who are younger than 50 years old.For the severity of herpes zoster,the difference does not have a statistical significance while for the pain suffered by different patients,the difference has a statistical significance;patients at the age of 50-59 years old,60-69 years old and more than 70 years old will get a higher pain than the patients younger than 50 years old.Patients older than 70 years old will experience a longer first visit and spend more time in hospital.Patients who have postherpetic neuralgia are older than those who do not have postherpetic neuralgia.For the days of first visit,patients who have postherpetic neuralgia spend more days on first visit than those who do not have postherpetic neuralgia;patients who have postherpetic neuralgia get a higher pain than those who do not have postherpetic neuralgia.There are less patients younger than 50 years old suffering postherpetic neuralgia than patients at the age of 50-59 years old and 60-69 years old;there are less patients at the age of 50-59 years old and 60-69 years old than patients older than 70 years old.For the effective rate owned by each group,the difference has a statistical significance---the effective rate of patients younger than 50 years old is higher than other patients;the effective rate of patients at the age of 50-59 years old and 60-69 years old is better than patients older than 70 years old.2.The research collects the blister fluid from 124 patients suffering herpes zoster,whose nucleic acid is tested.It is found that 94 patients have their nucleic acid positive;for the blister liquid got from 5 patients suffering chicken pox,3 have their nucleic acid positive.That is there are 75.2%patients have their nucleic acid positive.For 97 isolates got from VZV,there are 88 isolates in J genotyping while 9 isolates in M1 genotyping.For ORF38,all have PstI Hindlll;for ORF54,all have BglI Hindlll.Therefore,it is concluded that 97 VZV in Kunming are all in PstI+BglI+SmaI-genotyping.Then make a statistic on the 97 patients whose nucleic acid are positive,which is to be compared with VZV genotyping,it is found that there is no statistical significance between VZV genotyping and sex and age.However,there is a statistical significance between VZV genotyping and nationality.That is Han people suffer J genotyping more than others while Hui people and Yi people etc suffer M1 genotyping more than Han people.[Conclusions]1.Actually,herpes zoster is mainly suffered by middle aged and elderly people who are older than 50 years old,which will be suffered more along with the growth of age.Normally,herpes zoster is highly occurred in summer and autumn.Besides,elderly people get a more severe pain than young and middle aged people,who also need a longer time to get themselves recovered.The pain resulted in by skin rash and the age of patients' can well predict the postherpetic neuralgia.If the cure is started early,the pain can be efficiently lowered so that the patients will have a better life.What's more,the early cure can probably prevent some complications.By analyzing the clinical features of patients suffered herpes zoster(like the age and skin rash),as well as the severity suffered by different patients,the recovery time needed by the patients and the effect on lowering pains by different cure proposals,more clinical data can be provided for the cure of herpes zoster.In this way,doctors will get a better understanding on herpes zoster and they can better deal with herpes zoster.In addition,the possibility of complications will be lowered and patients' life will be greatly improved.2.The experiment successfully extracts 97 clinical isolates from 129 patients who suffer VZV virus.75.2%patients have their virus positive.From the analysis on genotyping,it is k:nown that among 97 patients suffering VZV virus in Kunming,88 patients have their isolates in J genotyping while 9 in M1 genotyping.It means that the inheritance of VZV is highly conservative and pleomorphic.All 97 samples are in the genotyping of PstI + BglI+.The Hindlll is different from that of Oka vaccine strain(in the genotyping of PstI+BglI+SmaI-),which means that all the isolates are VZV wild strains.According to this experiment,it is known that J genotyping is more highly suffered by Han people while M1 genotyping is more highly suffered by Hui people and Yi people than Han people.Perhaps,it means that the distribution of VZV in Kuming is affected by nationality,that is different nationality will have a different susceptibility to different genotyping.