带状疱疹与帕金森病和痴呆症之间的关联：一项系统评价和荟萃分析。

Association between herpes zoster and Parkinson's disease and dementia: a systematic review and meta-analysis.

作者信息

Zhang Yanfeng, Liu Weiping, Xu Yang

机构信息

Department of Dermatology, Tangshan Fengnan Hospital of Traditional Chinese Medicine, Tangshan, China.

Department of Dermatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.

出版信息

Front Neurol. 2024 Dec 5;15:1471736. doi: 10.3389/fneur.2024.1471736. eCollection 2024.

DOI:10.3389/fneur.2024.1471736

PMID:39703359

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11655326/

Abstract

OBJECTIVES

This meta-analysis investigated the relationship between herpes zoster and the risk of dementia or Parkinson's disease by analyzing published clinical studies.

METHODS

We systematically searched PubMed, Cochrane, Embase, and Web of Science Core Collection databases on April 25, 2024. Hazard ratios (HR) were used for statistical analyses. Random-effects models were applied, and heterogeneity was assessed using the I statistic.

RESULTS

Herpes zoster was associated with a non-significant trend toward increased dementia risk (HR = 1.11, 95% CI 0.99-1.24,  = 0.07) but significantly increased Parkinson's disease risk (HR = 1.15, 95% CI 1.03-1.30,  = 0.02). Subgroup analyses revealed that herpes zoster significantly elevated the risk of the prospective study subgroup (HR = 1.08, 95% CI 1.02-1.13,  = 0.004) and vascular dementia subgroup (HR = 1.17, 95% CI 1.00-1.37,  = 0.05). Significant heterogeneity was observed for both outcomes (dementia:  = 98%,  < 0.00001; Parkinson's disease:  = 94%,  < 0.00001).

CONCLUSION

Herpes zoster raises the risk of Parkinson's disease and vascular dementia, with a potential causal link to dementia. Early vaccination against herpes zoster is recommended over post-infection antiviral treatment to mitigate risks.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/ and our registration number is CRD42024555620.

摘要

目的

本荟萃分析通过分析已发表的临床研究，探讨带状疱疹与痴呆或帕金森病风险之间的关系。

方法

我们于2024年4月25日系统检索了PubMed、Cochrane、Embase和Web of Science核心合集数据库。采用风险比（HR）进行统计分析。应用随机效应模型，并使用I统计量评估异质性。

结果

带状疱疹与痴呆风险增加呈非显著趋势相关（HR = 1.11，95%置信区间0.99 - 1.24， = 0.07），但与帕金森病风险显著增加相关（HR = 1.15，95%置信区间1.03 - 1.30， = 0.02）。亚组分析显示，带状疱疹显著提高了前瞻性研究亚组（HR = 1.08，95%置信区间1.02 - 1.13， = 0.004）和血管性痴呆亚组（HR = 1.17，95%置信区间1.00 - 1.37， = 0.05）的风险。两种结果均观察到显著的异质性（痴呆： = 98%， < 0.00001；帕金森病： = 94%， < 0.00001）。