基于结构方程模型的带状疱疹后神经痛影响因素分析

Analysis of Influencing factors of postherpetic neuralgia based on Structural equation model

摘要:

摘 要 目的：基于结构方程模型探讨带状疱疹后神经痛各影响因素之间的关 系。方法：2012 年 1 月～2022 年 12 月于华中科技大学协和深圳医院住院的 带状疱疹（HZ）及带状疱疹后神经痛（PHN）资料完整的病例 627 例,将病例 按照有无带状疱疹后神经痛分为 PHN 组和非 PHN 组，采用单因素和 Logistic 回归分析筛选发生 PHN 的危险因素，并基于结构方程模型分析带状疱疹后神 经痛各因素间的关系。结果：共纳入 627 例 HZ 病人，按 PHN 发生情况分为 PHN 组（156 例）和非 PHN 组（471 例）。Logistic 回归分析筛选出性别、年 龄、皮疹面积、急性期疼痛评分、感觉异常、糖尿病、癌症共 6 个危险因素。 结构方程模型显示，性别、年龄、皮疹面积、急性期疼痛评分、感觉异常、糖 尿病、癌症均对 PHN 有直接效应，其路径系数分别为 0.124、0.198、0.116、 0.075、0.234、0.082、0.085；年龄、糖尿病对 PHN 具有直接与间接影响， 其总路径系数分别为 0.234、0.124。结论：PHN 受性别、年龄、皮疹面积、 急性期疼痛评分、感觉异常、糖尿病、癌症等多种因素影响，年龄、糖尿病对 PHN 具有直接与间接影响。

Abstract:

Abstract Objective: Based on structural equation model to explore the relationship between the influencing factors of postherpetic neuralgia. Method: From January 2012 to December 2022, 627 cases with complete data of herpes zoster (HZ) and postherpetic neuralgia (PHN) were hospitalized in Union Shenzhen Hospital of Huazhong University of Science and Technology. The cases were divided into PHN group and non-PHN group according to the condition of postherpetic neuralgia. The risk factors of PHN were screened by univariate and Logistic regression analysis, and the relationship between the factors of postherpetic neuralgia was analyzed based on structural equation model. Results: A total of 627 HZ patients were included and divided into PHN group (156 cases) and non-PHN group (471 cases) according to the occurrence of PHN. Logistic regression analysis screened out 6 risk factors including gender, age, rash area, acute pain score, paresthesia, diabetes and cancer. The structural equation model showed that gender, age, skin rash area, acute pain score, paresthesia, diabetes and cancer had direct effects on PHN, and the path coefficients were 0.124, 0.198, 0.116, 0.075, 0.234, 0.082 and 0.085, respectively. Age and diabetes had direct and indirect effects on PHN, and the total path coefficients were 0.234 and 0.124, respectively. Conclusions: PHN is affected by gender, age, rash area, acute pain score, paresthesia, diabetes, cancer and other factors. Age and diabetes have direct and indirect effects on PHN.