阿霉素椎间孔周围注射对带状疱疹后神经痛疗效影响的多因素分析

The influencing factors analysis of doxorubicin non-vascular interventional treatment for herpes zoster neuralgia

中文关键词: 多柔比星  带状疱疹  神经痛  疗效分析

英文关键词: Doxorubicin  Herpes zoster  Neuralgia  Effect analysis

中文摘要:

      目的：评价阿霉素治疗胸背部带状疱疹后神经痛(postherpetic neuralgia,PHN)的疗效及影响疗效的因素分析。方法选择2010年1月至2014年1月在天津医科大学第二医院连续就诊的胸背部带状疱疹后遗神经痛患者209例,男94例,女115例,年龄45~86岁。所有患者接受阿霉素非血管介入治疗,采用 VAS 评分评价远期疗效。采用单因素和多因素 Logistic 回归分析影响疗效的因素。结果1个月总有效173例(82.76%),12个月总有效180例(86.12%)。单因素分析结果显示年龄≤65岁、病程<3个月、重度疼痛(VAS 评分≥7分)、伴免疫力低下疾病、近期疗效(1个月有效率)与阿霉素治疗 PHN 的疗效明显相关(P <0.05)。多因素分析结果显示伴恶性肿瘤等免疫力低下疾病(OR =1.418,95%CI 1.347~8.563)和病程≥3个月(OR =2.408,95%CI 3.325~18.643)是影响疗效的独立危险因素。结论伴恶性肿瘤等免疫力低下疾病和病程≥3月的带状疱疹后神经痛患者,接受阿霉素椎间孔周围注射治疗后疗效可能较差,应及早进行治疗。

英文摘要:

      Objective To evaluate the efficacy and influencing factors analysis of doxorubicin treatment for herpes zoster neuralgia postherpetic neuralgia (PHN).Methods From January 2010 to January 2014 in the Second Hospital of Tianjin Medical University,209 cases of herpes zoster neural-gia patients (94 males,1 1 5 females,aged 45-86 years)received doxorubicin non-vascular interven-tional treatment,using visual analogue scale (visual analogue scale,VAS score)to evaluate curative effect,then recorded the related factors of patients (gender,age,location,duration,and degree of pain,whether to have hypoimmunity disease,early antiviral treatment,the presence of hyperalgesia, and outbreak pain,drug concentration,guiding method,the recent curative effect).Using single-fac-tor analysis of variance procedure and multiple factors of logistic regression analysis.Results The to-tal effective rate was 82.76% (1 73/209)after one month,the total effective rate was 86.12% (180/209)after twelve months.Single factor analysis showed that age≤65 years,duration of diseases<3 months,severe pain(VAS≥ 7 )or with low immunity disease was significantly associated with the curative effect of treatment of PHN (P <0.05).Multi-factor analysis showed that with low immunity diseases such as malignant tumor (OR =1.418,95%CI 1.347-8.563),the course of the disease more than 3 months (OR = 2.408,95% CI 3.325-18.643 ) were independent prognostic factors of influencing curative effects.Conclusion With low immunity diseases such as malignant tumor and the duration of more than 3 months,curative effect of doxorubicin non-vascular interventional treatment may be poor,patients should be treated as early as possible.