目的:对带状疱疹后遗神经痛(PHN),带状疱疹(HZ)患者的基线特征,早期干预。
方法:在七个数据库中进行文献检索,2021年6月,2022年6月更新。两名研究者独立进行文献筛选和数据提取,并根据纽卡斯尔-渥太华量表对研究进行评估。
结果:共纳入53项队列研究。荟萃分析确定了皮肤损伤,初始治疗时间(≥3天),合并症是PHN的潜在危险因素。相比之下,女性(优势比[OR]=1.13,95%置信区间[CI]:0.99-1.29),宫颈疱疹(OR=0.80,95%CI:0.21-2.99),腰椎疱疹(OR=1.29,95%CI:0.61-2.74),和免疫抑制治疗(OR=1.96,95%CI:0.22-17.12),与PHN无显著相关性。此外,糖皮质激素的使用(OR=0.61,95%CI:0.22-1.70)可能是PHN发展的保护因素;然而,差异无统计学意义。
结论:在从HZ发展为PHN的高风险人群中确定了一系列基线特征。此外,初始治疗的时机与PHN发生相关。糖皮质激素的预防作用值得进一步验证。
OBJECTIVE: To conduct a meta-analysis of the association between postherpetic neuralgia (PHN), baseline characteristics of patients with herpes zoster (HZ), and early interventions.
METHODS: Literature searches were conducted in seven databases, in June 2021 and updated in June 2022. Two investigators independently conducted literature screening and data extraction, and the studies were evaluated according to the Newcastle-Ottawa scale.
RESULTS: A total of 53 cohort studies were included. The meta-analyses identified skin lesions, timing of initial treatment (≥3 days), and comorbidities as potential risk factors for PHN. In contrast, female sex (odds ratio [OR] = 1.13, 95% confidence interval [CI]: 0.99-1.29), cervical herpes (OR = 0.80, 95% CI: 0.21-2.99), lumbar herpes (OR = 1.29, 95% CI: 0.61-2.74), and immunosuppressive therapy (OR = 1.96, 95% CI: 0.22-17.12), were not significantly associated with PHN. In addition, glucocorticoid use (OR = 0.61, 95% CI: 0.22-1.70) may be a protective factor for the development of PHN; however, the difference was not statistically significant.
CONCLUSIONS: A series of baseline characteristics were identified among populations at high risk of developing PHN from HZ. Additionally, the timing of initial treatment is associated with PHN occurrence. The preventive effect of glucocorticoids warrants further validation.