目的：探讨恶性血液病患者治疗过程中合并带状疱疹的发病情况、危险因素、治疗及预后。方法回顾性分析21例合并带状疱疹的恶性血液病患者的临床资料。结果741例恶性血液病患者中有21例合并带状疱疹，发生率为2.8%。感染发生部位多位于胸、腰部皮肤。中位发病时间为化疗开始后4.5个月。年龄≥45岁的患者带状疱疹发生率明显高于﹤45岁患者（3.9% vs 0.8%，P ＝0.01）。采用含利妥昔单抗化疗方案的患者带状疱疹发生率显著高于不含利妥昔单抗化疗方案的患者（7.0% vs 2.3%，P ＝0.026）。治疗以静脉滴注阿昔洛韦或阿糖腺苷为主要方案，平均病程为12 d，2例高龄患者同时合并真菌感染死亡，其余患者均治愈。结论恶性血液病患者合并带状疱疹的发生率较正常人群明显增高；年龄≥45岁、应用利妥昔单抗可能是其发生的危险因素；通过有效抗病毒治疗，可使大部分患者获得痊愈；对于免疫力异常低下患者，合并带状疱疹提示预后不良。%Objective To investigate the incidence,characteristics,treatment and outcomes of herpes zoster in the patients with hematopoietic malignancies. Methods The clinical data of 21 cases of herpes zoster patients with hematopoietic malignancies were retrospectively collected and analyzed. Results 21 patients(2. 8% )were found with herpes zoster out of 741 patients with hematopoietic malignancies. The infection was commonly found in skin of chest and waist. The mean onset time is 4. 5 months after initial chemotherapy. The incidence of herpes zoster in pa-tients who were no less than 45 is significantly higher than those who were less than 45(3. 9% vs 0. 8% ,P =0. 01). Besides,this incidence is also significantly higher in patients who received rituximab therapy that those who didn’t receive rituximab therapy(7. 0% vs 2. 3% ,P =0. 026). With the treatment of acyclovir and(or)arabinosyl adenine by intravenous infusion,most cases were cured within an average time of 12 days. Only 2 old-aged patients died be-cause of complication of fungal infection. Conclusion Patients with hematopoietic malignancies are more easily to be infected by herpes varicella-zoster virus. An age no less than 45 and rituximab treatment history are high risk factors for herpes varicella-zoster virus infection. Most patients could be cured by effective anti-virus therapy. But for old-aged immunocompromised patients,infection of herpes varicella-zoster virus may cause high death rate.
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