60세 이상과 60세 미만의 눈대상포진 환자에서 임상양상의 비교
Comparison of Herpes Zoster Ophthalmicus in Patients 60 Years Older Versus Younger than 60 Years
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목적: 60세를 기준으로 연령에 따른 눈대상포진의 임상양상의 차이를 알아보고자 하였다. 대상과 방법: 2002년 2월부터 2011년 2월까지 눈대상포진으로 진단받고 본원에서 3개월 이상 경과관찰을 시행한 환자를 60세 미만과60세 이상으로 나누고 이들의 의무기록을 분석하여 임상양상을 조사하였다. 결과: 63명의 환자 중 60세 미만이 29명(46%), 60세 이상이 34명(54%)이었다. 연령에 따른 발생빈도를 살펴보았을 때 60대에서 가장호발하였다. 각 군에 따른 성별, 침범안 등은 차이를 보이지 않았다. 가성수지상각막염은 젊은환자군에서 높게 나타났으며(p=0.014),포진 후 신경통은 노인환자군에서 높게 나타났다(p=0.046). Hutchinson’s sign이 있는 경우 가성수지상각막염과(p˂0.05), 포도막염(p=0.04), 결막염(p=0.02)의 합병증이 흔하게 나타났다. 결론: 안부 대상포진은 연령에 따라 임상양상의 차이가 있으므로 적절한 치료가 필요하며, 특히 노인환자에서 Hutchinson’s sign이발견된다면 적극적인 초기 치료가 필요할 것으로 생각한다.
Abstract
Purpose: To analyze and compare the clinical characteristics of patients with herpes zoster ophthalmicus (HZO) by age groups on the basis of the age of 60. Methods: Medical records of patients with HZO who visited Chonbuk National University Hospital from February 1, 2002 to February 28, 2011 were reviewed. The patients with follow-up of three months or more were divided into two groups: patients under 60 and patients with 60 years old and over. The clinical characteristics between two groups were examined through the analysis of their medical records. Results: Among a total of 63 patients, 29 patients (46%) were under 60 years old, and 34 patients (54%) were 60 years old and over. Incidence of HZO highest in the sixties. The sex and intrusion of each group showed no difference. Younger patients had a higher incidence of pseudodendrite by HZO (86.2% vs. 58.8%, p = 0.014) compared with older patients who showed a higher incidence of post herpetic neuralgia (13.8% vs. 35.3%, p = 0.046). As patients showed Hutchinson's sign,they often had more ocular complications such as pseudodendrite (100% vs. 64.7%, p < 0.05), uveitis (41.7% vs. 7.8%, p = 0.04), and conjunctivitis (100% vs. 90.2%, p = 0.02). Conclusions: Herpes zoster ophthalmicus shows different clinical characteristics according to patients' age and requires appropriate treatment. Especially elderly patients showing Hutchinson's sign should be treated early and aggressively enough.
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