| Objectives: The clinical data of inpatients with herpes zoster（HZ）in recent years were collected.To identify the demographic characteristics such as gender and age of the incidence population and clinical characteristics such as season of onset,precipitating factors,prodromal symptoms,involved nerves,and complications.To further explore the incidence of postherpetic neuralgia（PHN）and related risk factors.In order to provide reference for clinical prevention and control of HZ and PHN.Methods: The clinical data of 599 inpatients diagnosed with HZ in a tertiary hospital from January 2013 to July 2021 were retrospectively analyzed.SPSS 25.0statistical software was used to analyze the clinical characteristics of patients by descriptive statistics,nonparametric test and chi-square test.213 inpatients with HZ were followed up by telephone from January 2019 to July 2021.The incidence of PHN was statistically analyzed,and the related risk factors of PHN were analyzed by univariate analysis and multivariate logistic regression analysis.Results:1)A total of 599 clinical data of HZ inpatients were included in this study.Among them,311 cases（51.9%）were male and 288 cases（48.1%）were female,with a male-to-female ratio of 1.08:1.The mean age of onset was 57.17±14.91 years old and peak incidence at 50-69 years old.2)The seasons with more frequent onset of HZ in Lanzhou were spring（29.2%）and autumn（26.0%）.41.3% of patients had a clear trigger before onset,with exertion being the most common.52.9% had at least one comorbidity,most commonly hypertension and diabetes mellitus.Age was negatively correlated with the presence of a trigger（r =-0.189,P < 0.001）and positively correlated with comorbidity（r =0.292,P < 0.001）.67.7% of HZ patients had local or systemic prodromal symptoms prior to rash onset,with pain being the most common（58.6%）.The probability of prodromal pain was higher with intercostal nerve involvement（P = 0.006）.3)Among the patients with herpes zoster,51.9% occurred on the right side of the body and 48.1% occurred on the left.The probabilities of HZ involving cranial nerve,cervical nerve,intercostal nerve and lumbosacral nerve were 32.2%,13.4%,42.2 %and 12.2%,respectively,with differences in the predominantly involved nerves by age（P = 0.020）.Inpatients with HZ were mainly moderate pain（60.9%）and common skin lesions（86.1%）.Severe lesions were more likely to occur in males and lumbosacral nerves involvement（P = 0.023,P = 0.002）.4)Patients with at least one acute complication accounted for 20.03%.The probability of skin,eyes,nervous system and visceral complications was 7.18%,9.52%,1.84% and 3.67%,respectively.Secondary bacterial infection in primary lesions is the most common acute complication.Acute complications were more likely to occur when cranial nerves were involved（P < 0.001）.5)In 213 patients hospitalized with HZ in the last 3 years of follow-up,67 developed PHN,with an incidence of 31.5%.Univariate analysis showed that age,comorbidity,lesion type,lesion severity,intensity of acute pain,monocyte count,fasting blood glucose,iron and procalcitonin were risk factors associated with PHN（P< 0.05）.Multivariate logistic regression analysis showed that age ≥ 50 years（OR =5.531）,severe skin lesions（OR = 3.723）,severe pain in the acute phase（OR = 4.865）,elevated monocyte count（OR = 9.953）and decreased iron（OR = 0.932）were independent risk factors for PHN（P < 0.05）.Conclusions: HZ was common in the elderly and usually occurred in spring and autumn in Lanzhou.The onset of HZ was often preceded by a definite trigger in patients < 50 years and a combination of comorbidity in patients ≥ 50 years.Pain was the most common prodromal symptom and was most often seen with intercostal nerve involvement.Acute complications occurred in 20.03% of patients with HZ and were more likely to occur with cranial nerve involvement.Secondary bacterial infection at the primary lesion was the most common acute complication.The incidence of PHN was 31.5%.The risk factors for PHN included age ≥ 50 years old,severe skin lesions,severe acute pain,monocyte count increase and serum iron loss. |
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