Analysis Of Risk Factors Of Herpes Zoster Infection In Patients With Rheumatic Disease

Objective:To investigate the risk factors of herpes zoster(HZ)infection in patients with rheumatic diseasesMethods:A total of 780 patients with rheumatic diseases were enrolled at the First Affiliated Hospital of Nanchang University since February 2018 to February 2020who performed T lymphocyte subgroup tests.All patients were followed up for 1 year.A total of 70 patients with HZ infection were observed.140 patients were randomly selected from the total group as the control group according to the 1:2 principle of matching according to disease category.The basic clinical data,laboratory test results,and drug use were compared between the two groups,and the risk factors for herpes zoster were analyzed.Results:1.Among the 780 patients with rheumatism enrolled,SLE(441 cases,56.54%),rheumatoid arthritis(82 cases,10.51%),and myositis(71 cases,9.1%).A total of 70cases(8.97%)of rheumatism patients had herpes zoster infection.There are statistical differences in the infection rate of herpes zoster in patients with different types of rheumatism(χ~2=23.09,P=0.003).The age of rheumatism patients infected by herpes zoster is(48.86±13.82)years old,the male to female ratio is 1:2.89,and other underlying diseases include diabetes,tumors,coronary heart disease,and chronic renal insufficiency.2.Single factor analysis prompts:the number of types of combined other underlying diseases,the average dose of glucocorticoid used in the past month,the number of types of immunosuppressants used,the cumulative amount of cyclophosphamide,CD4+T cells,CD4/CD8,complement C4 are associated with increased risk of HZ infection,The difference is statistically significant.There was no statistically significant difference in lymphocyte ratio and the use of high-dose hormones.3.Multi-factor analysis suggests that the number of types of immunosuppressants used,the average dose of glucocorticoid used in the past month,the cumulative amount of cyclophosphamide,CD4/CD8,and complement C4 are independent risk factors for HZ infection.4.The prediction performance of ROC curve detection shows that CD4/CD8(AUC=0.786,P<0.001),the average dose of glucocorticoid used in the past month(AUC=0.753,P<0.001),and the number of types of immunosuppressants used(AUC=0.740,P<0.001)are of greater value in predicting rheumatism patients with herpes zoster infection.Conclusion:The incidence of herpes zoster infection in patients with rheumatism is higher than that of the general population.the average dose of glucocorticoid used in the past month,the number of types of immunosuppressants used,the low complement C4,the cumulative amount of cyclophosphamide,and the decrease of CD4/CD8 are also independent risk factors for herpes zoster infection in patients with rheumatism,Is highly correlated with the increased risk of HZ infection.And decrease in CD4/CD8 has the greatest predictive value for the occurrence of herpes zoster infection in patients with rheumatism.