Torcel-Pagnon Laurence, Bricout Hélène, Bertrand Isabelle, Perinetti Emilia, Franco Elisabetta, Gabutti Giovanni, Volpi Antonio
Sanofi Pasteur MSD, Lyon, France.
Sanofi Pasteur MSD, Roma, Italy.
J Gerontol A Biol Sci Med Sci. 2017 Aug 1;72(8):1091-1097. doi: 10.1093/gerona/glw189.
Chronic conditions have been investigated as risk factors for developing zoster, but in patients suffering from zoster, the impact of underlying conditions in zoster-related pain and quality of life (QOL) remains unclear.
We performed a post hoc analysis of a prospective cohort study in immunocompetent zoster patients aged 50 years or older, conducted by general practitioners in Italy between 2009 and 2010. Zoster symptoms, pain intensity and characteristics, and physical and mental health scores were assessed at baseline (zoster diagnosis) and at 1, 3, and 6 months of follow-up.
Among 413 patients enrolled in the study, 73% (303/413) suffered from underlying conditions of which 69% (209/303) were aged 65 or older. Cardiovascular diseases (75%), diabetes (24%), and respiratory diseases (17%) were most frequent. One to three months after onset, zoster patients with underlying conditions experienced more intense zoster-related pain than those without. QOL scores were significantly lower in patients with underlying conditions, and age-adjusted difference in QOL scores between the groups increased over time, demonstrating a slower recovery for patients with underlying conditions.
In addition to age, the main risk factor of zoster occurrence and severity, the presence of underlying conditions results in more painful and impactful zoster episodes, creating a significant burden for these patients.
慢性病已被作为带状疱疹发病的风险因素进行研究，但在带状疱疹患者中，基础疾病对带状疱疹相关疼痛及生活质量的影响仍不明确。
我们对意大利全科医生在2009年至2010年间开展的一项针对50岁及以上免疫功能正常的带状疱疹患者的前瞻性队列研究进行了事后分析。在基线（带状疱疹诊断时）以及随访的1个月、3个月和6个月时评估带状疱疹症状、疼痛强度及特征，以及身心健康评分。
在纳入研究的413例患者中，73%（303/413）患有基础疾病，其中69%（209/303）年龄在65岁及以上。心血管疾病（75%）、糖尿病（24%）和呼吸系统疾病（17%）最为常见。发病后1至3个月，患有基础疾病的带状疱疹患者经历的带状疱疹相关疼痛比无基础疾病的患者更强烈。有基础疾病患者的生活质量评分显著更低，且两组间经年龄调整后的生活质量评分差异随时间增加，表明有基础疾病的患者恢复较慢。
除了年龄（带状疱疹发生和严重程度的主要风险因素）外，基础疾病的存在导致带状疱疹发作时疼痛更剧烈、影响更大，给这些患者造成了重大负担。
