Chen Dongying, Li Hao, Xie Jingyi, Zhan Zhongping, Liang Liuqin, Yang Xiuyan
Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China.
Department of Rheumatology, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China.
Exp Ther Med. 2017 Dec;14(6):6222-6228. doi: 10.3892/etm.2017.5297. Epub 2017 Oct 12.
Herpes Zoster (HZ) is reported as the most prevalent viral infection in patients with systemic lupus erythematosus (SLE). The aim of the present study was to investigate the clinical features, complications, and potential risk factors of HZ in patients with SLE from Southern China. A retrospective study was performed among patients with SLE admitted to the First Affiliated Hospital of Sun Yet-Sen University (Guangzhou, China) between 2009 and 2013. Demographic information, clinical and laboratory data, and medications used were collected and analyzed. A total of 48 instances of HZ from 46 individuals in a cohort of 1,265 SLE patients during the follow-up period were identified, with an overall prevalence of 3.6%. Complications occurred in 23.9% of patients with HZ (11/46). The risk of HZ was highest within 3-6 months following SLE diagnosis and reduced thereafter. The multivariate logistic regression analysis demonstrated that lymphopenia (OR=4.6; 95% CI=1.5-13.8; P=0.006) and treatment with high-dose glucocorticoids (GC; OR=4.3; 95% CI=1.6-11.7; P=0.004) were both significantly associated with occurrence of HZ. Lymphopenia was the only independent risk factor for the occurrence of complicated HZ (OR=15.2; 95% CI=2.7-85.1; P=0.002). There are some notable characteristics of HZ in patients with SLE in Southern China, such as the tendency to manifest in an early stage of SLE, and frequent complications with benign outcomes. The present data supported the role of lymphopenia and high-dose of GC therapy as risk factors for the occurrence of HZ. Lymphopenia was also shown to contribute to complicated HZ.
据报道，带状疱疹（HZ）是系统性红斑狼疮（SLE）患者中最常见的病毒感染。本研究旨在调查中国南方SLE患者HZ的临床特征、并发症及潜在危险因素。对2009年至2013年期间在中山大学附属第一医院（中国广州）住院的SLE患者进行了一项回顾性研究。收集并分析了人口统计学信息、临床和实验室数据以及使用的药物。在1265例SLE患者队列的随访期间，共识别出46例患者发生的48例HZ病例，总体患病率为3.6%。23.9%的HZ患者（11/46）出现了并发症。HZ的风险在SLE诊断后的3至6个月内最高，此后降低。多因素逻辑回归分析表明，淋巴细胞减少（OR=4.6；95%CI=1.5-13.8；P=0.006）和大剂量糖皮质激素（GC）治疗（OR=4.3；95%CI=1.6-11.7；P=0.004）均与HZ的发生显著相关。淋巴细胞减少是发生复杂性HZ的唯一独立危险因素（OR=15.2；95%CI=2.7-85.1；P=0.002）。中国南方SLE患者的HZ有一些显著特征，如倾向于在SLE早期表现，且并发症频繁但预后良好。目前的数据支持淋巴细胞减少和大剂量GC治疗作为HZ发生的危险因素的作用。淋巴细胞减少也被证明与复杂性HZ有关。
