Clinical Characteristics of Varicella-zoster Virus Infection in 38 Immunocompromised Patients
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摘要:
目的 探讨免疫低下人群感染水痘-带状疱疹病毒（varicella-zoster virus，VZV）的临床特征。 方法 收集昆明市第三人民医院2020年1月至2021年12月间，收治的免疫低下人群感染VZV38例为观察组，40例普通人群感染VZV为对照组，对其临床资料进行回顾性的分析，观察2组的心肌酶、肝功能、肾功能等评估脏器功能的指标；以及IL-6、IL-8、CD+4 T淋巴细胞等评估机体免疫的指标。 结果 将2组的肝功能、心肌酶进行对比，观察组GGT/AST/ALT、LDH/CK 均高于对照组，差异有统计学意义（P < 0.05）。将2组的CREA进行对比： 2组人群CREA，差异无统计学意义（ P > 0.05）。2组的细胞因子IL-6、IL-8对比；观察组IL-6、IL-8均高于对照组，差异有统计学意义（ P < 0.05）。2组CD4 ＋T淋巴细胞数对比，观察组CD4＋T淋巴细胞数低于对照组，差异有统计学意义（P < 0.05）。 结论 免疫低下人群感染VZV，由于免疫被抑制，更容易诱发细胞因子风暴，病情更重，常易合并器官功能障碍甚至衰竭，病情进展快，若能早期识别，积极救治，能改善其预后。 Abstract:Objective To investigate the clinical characteristics of varicella-zoster virus （VZV） infection in immunocompromised population. Methods From January 2020 to December 2021 in the Third People’s Hospital of Kunming, 38 cases of VZV infection in immunosuppressed population were selected as the observation group, and 40 cases of VZV infection in the general population were selected as the control group. The clinical data were retrospectively analyzed, and the indexes of cardiac enzymes, liver function, kidney function and other organs function evaluation in the two groups were observed. And IL-6, IL-8, CD+4 T lymphocytes and other indicators’s data were analyzed to evaluate the body’s immunity. Results The GGT/AST/ALT and LDH/CK of the observation group were significantly higher than those of the control group （P < 0.05）. There was no statistical significance in CREA between the two groups （ P > 0.05）. IL-6 and IL-8 in the observation group were significantly higher than those in the control group （ P < 0.05）. The number of CD4+T lymphocytes in the observation group was significantly lower than that in the control group （ P < 0.05）. Conclusion Immunocompromised population with VZV infection are more likely to induce cytokine storm, and are more often complicated with organ dysfunction or even organ failure. The disease progresses faster and is more severe. Early identification and treatment can improve the prognosis. -
Key words:
- Immunocompromised population /
- Varicella-zoster virus /
- Clinical signs /
- Analysis
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表 1 观察组与对照组出疹持续时间及发热持续时间对比（ $ \bar x \pm s $）
Table 1. Comparison of eruption duration and fever duration between observation group and control group （ $ \bar x \pm s $）
分组 出疹持续时间（d） 发热持续时间（d） 对照组 3.0 ± 0.6 3.1 ± 0.7 观察组 6.00 ± 1.7 6.000 ± 1.7 t 9.439 -9.240 P 0.000* 0.000* *P < 0.05。 
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表 2 观察组与对照组肝功能、肾功能、心肌酶对比（ $ \bar x \pm s $）
Table 2. Comparison of liver function，renal function and myocardial enzymes between the observation group and the control group （ $ \bar x \pm s $）
分组 肝功能 肾功能 心肌酶 GGT（U/L） AST（U/L） ALT（U/L） CREA（μmol/L） LDH
（U/L）CK
（U/L）观察组 100.3 ± 158.91 84.11 ± 135.97 80.171 ± 130.11 80.80 ± 146.89 573.26 ± 952.70 128.20 ± 148.34 对照组 36.79 ± 31.79 29.76 ± 14.78 24.82 ± 3.14 57.68 ± 18.11 232.85 ± 68.30 74.38 ± 32.83 t 2.286 2.317 2.456 2.078 2.066 P 0.025* 0.024* 0.017* 0.366 0.042* 0.043* *P < 0.05。
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表 3 观察组与对照组的IL-6、IL-8、CD4＋T淋巴细胞数对比（ $ \bar x \pm s $）
Table 3. IL-6，IL-8 and CD4+T lymphocytes counts was compared between the observation group and the control group （ $ \bar x \pm s $）
分组 IL-6（pg/mL） IL-8（pg/mL） CD4＋T淋巴细胞数（个/μL） 对照组 15.24 ± 13.49 31.56 ± 20.69 786.75 ± 359.14 观察组 88.66 ± 213.02 93.88 ± 100.58 445.66 ± 354.26 t 2.005 3.540 −3.971 P 0.049* 0.001* 0.000* *P < 0.05。
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