A Prospective Study of the Herpes Zoster Severity of Illness
A Prospective Study of the Herpes Zoster Severity of Illness
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DOI：
10.1097/ajp.0b013e3181eef686
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发表时间：
2010-10-01
影响因子：
2.9
通讯作者：
Mansi, James A.
中科院分区：
文献类型：
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作者：
Drolet, Melanie;Brisson, Marc;Mansi, James A.
目的：MASTER是一项多中心前瞻性研究，旨在全面了解带状疱疹（HZ）和带状疱疹后神经痛（PHN）的负担。目标是：（1）描述带状疱疹疾病严重程度（HZSOI），一种疼痛持续时间和严重程度的综合指标;（2）确定在HZ不同阶段预测更大HZSOI的招募特征。从2005年10月到2006年7月，在加拿大各地招募了261名年龄超过50岁的HZ门诊患者，他们在皮疹发作的14天内发病。在招募时和7、14、21、30、60、90、120、150和180天后通过带状疱疹简明疼痛量表测量疼痛。HZSOI代表疼痛严重程度随时间变化的曲线下面积，范围从0（无疼痛）到1800（疼痛= 10持续180 d）。根据HZ的不同阶段，更大的HZSOI的预测因子不同。招募时疼痛严重程度较高、病变较多、收入较低和免疫功能低下是更严重急性HZSOI的预测因素。更高的急性疼痛的严重程度，较低的收入，免疫功能低下，年龄较大，没有接受抗病毒药物的预测更大的疱疹后HZSOI.Discussion：使用一个信息量的措施捕获同时造成的负担疼痛的持续时间和严重程度，我们确定了亚组遭受最在HZ的不同阶段。值得注意的是，在HZ急性期，年轻参与者与老年人一样可能遭受痛苦。这些信息应有助于优化HZ的治疗和预防。
Objective: MASTER, a multicenter prospective study, was conducted to provide a thorough understanding of the burden of herpes zoster (HZ) and postherpetic neuralgia (PHN). Objectives are to: (1) describe the herpes zoster severity-of-illness (HZSOI), a composite measure of pain duration and severity; and (2) to identify the characteristics at recruitment predictive of greater HZSOI at the different phases of HZ.Methods: From October, 2005 to July, 2006, 261 outpatients with HZ, aged more than equal to 50 years, were recruited within 14 days of rash onset across Canada. The pain was measured by the Zoster Brief Pain Inventory at recruitment and 7, 14, 21, 30, 60, 90, 120, 150, and 180 days later. The HZSOI represents the area under the curve of pain severity over time and ranges from 0 (no pain) to 1800 (pain = 10 for 180 d).Results: Median pain duration was 32.5 days. The predictors of greater HZSOI varied according to the different phases of HZ. Higher pain severity at recruitment, more lesions, lower income, and being immunocompromised were the predictors of a greater acute HZSOI. Higher acute pain severity, lower income, being immunocompromised, older age, and not receiving antivirals were the predictors of greater postherpetic HZSOI.Discussion: Using an informative measure capturing simultaneously the burden caused by pain duration and severity, we identified subgroups that suffer most during the different phases of HZ. It is interesting to note that, younger participants were as likely to suffer as the older ones during the acute phase of HZ. This information should aid in optimizing the treatment and prevention of HZ.