Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
Br J Dermatol. 2021 Jul;185(1):130-138. doi: 10.1111/bjd.19832. Epub 2021 May 7.
Psychological stress may reduce cellular immunity, but its role in triggering latent infections, including herpes zoster (HZ), is controversial.
To examine the association between perceived psychological stress and risk of HZ.
In a linked registry-based cohort study, we followed 77 310 persons aged 40 years or older who participated in the 2010 Danish National Health Survey from 1 May 2010 until HZ diagnosis, death, emigration or 1 July 2014, whichever occurred first. We computed hazard ratios (HRs) of HZ associated with Cohen's Perceived Stress Scale (PSS) score (range 0-40) using Cox regression with age as the timescale, adjusted for sex, immunosuppressive and selected chronic conditions, immunosuppressive drugs, and sociodemographic, lifestyle and anthropometric factors. The PSS measures chronic stress perceived by an individual in response to various demands of daily life. We modelled the PSS score using quintiles and a restricted cubic spline function.
The unadjusted rate of HZ varied from 5·53 to 7·20 per 1000 person-years from the lowest to the highest PSS score quintile. Compared with the lowest PSS score quintile, the adjusted HR for HZ was 1·00 [95% confidence interval (CI) 0·86-1·16], 1·08 (95% CI 0·92-1·26), 1·05 (95% CI 0·90-1·23) and 1·14 (95% CI 0·97-1·34) for the second to the fifth quintile, respectively. In cubic spline analyses, PSS scores < 20 were not associated with increased HR of HZ, but thereafter the HR increased linearly from 1·10 (95% CI 0·85-1·41) to 2·22 (95% CI 1·32-3·75).
Our study indicated that high levels of psychological stress are associated with increased risk of HZ.
心理压力可能会降低细胞免疫功能，但它在引发潜伏性感染（包括带状疱疹）方面的作用存在争议。
研究心理压力与带状疱疹发病风险的相关性。
在一项基于登记的队列研究中，我们对 77310 名年龄在 40 岁及以上、参加了 2010 年丹麦全国健康调查的人群进行了随访，随访时间从 2010 年 5 月 1 日开始，直到带状疱疹发病、死亡、移民或 2014 年 7 月 1 日，以先发生者为准。我们使用 Cox 回归模型，以年龄为时间尺度，根据性别、免疫抑制剂和选定的慢性疾病、免疫抑制剂药物以及社会人口统计学、生活方式和人体测量学因素对数据进行了调整，计算了带状疱疹发病风险与科恩感知压力量表（PSS）评分（范围 0-40）之间的危害比（HR）。PSS 量表用于衡量个体对日常生活中各种需求的慢性压力感知。我们使用五分位数和限制三次样条函数对 PSS 评分进行了建模。
在未调整的情况下，带状疱疹的发病率从最低到最高 PSS 评分五分位数分别为 5.53/1000 人年到 7.20/1000 人年。与最低 PSS 评分五分位数相比，调整后的带状疱疹发病 HR 分别为 1.00（95%置信区间：0.86-1.16）、1.08（95%置信区间：0.92-1.26）、1.05（95%置信区间：0.90-1.23）和 1.14（95%置信区间：0.97-1.34）。在三次样条分析中，PSS 评分＜20 与带状疱疹发病风险的 HR 增加无关，但此后 HR 呈线性增加，从 1.10（95%置信区间：0.85-1.41）增加到 2.22（95%置信区间：1.32-3.75）。
我们的研究表明，高水平的心理压力与带状疱疹发病风险增加有关。
