Demirkok S S, Basaranoglu M, Akbilgic O
Division of Lung Diseases, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
Int J Clin Pract. 2006 Nov;60(11):1443-50. doi: 10.1111/j.1742-1241.2005.00773.x.
Sarcoidosis is a chronic disease with an unknown aetiology. Our aim was to evaluate the pattern of seasonality of stage 1 sarcoidosis subjects who had symptoms by all cases, by age and by both genders. In this study, we used Roger's test for cyclic variation to prove that this seasonal variation was more than chance. Four hundred ninety-two consecutive patients with sarcoidosis who presented different clinical symptoms were included in this retrospective cohort study. According to the chest X-ray examinations, 185 patients had stage 1, while 307 patients in control group had stage 0, 2, 3 and 4 sarcoidosis. The demographic features, presenting clinical features, course of the disease, initial diagnostic methods and both the month and the age at the initial diagnosis for each patient were analysed on chart reviews. Roger's test for cyclic variation was used to determine the significance of any seasonal variation of incidence. Otherwise, t-test was used. The distribution of cumulative monthly presentations for patients with stage 1 peaked in April (108% above the average) and was lowest in October, November and December (48% below the average) (p < 0.001). Seasonality of the control group peaked in May (84% above the average) and was lowest in August (69% below the average) (p < 0.001). The seasonal pattern of subjects within both groups was influenced by some age groups and by both genders (p < 0.05). Some differences in the amplitude of the seasonal variation by age and by both genders increase the possibility of interactions among age, gender and the disease. Further well-designed and prospective studies are required to better understand the importance of our findings and the pathogenesis of the disease.
结节病是一种病因不明的慢性疾病。我们的目的是评估所有病例、按年龄和按性别划分的1期结节病有症状患者的季节性模式。在本研究中,我们使用罗杰循环变异检验来证明这种季节性变化并非偶然。这项回顾性队列研究纳入了492例连续出现不同临床症状的结节病患者。根据胸部X线检查,185例患者为1期,而对照组的307例患者为0、2、3和4期结节病。通过病历审查分析了每位患者的人口统计学特征、呈现的临床特征、病程、初始诊断方法以及初始诊断的月份和年龄。使用罗杰循环变异检验来确定发病率季节性变化的显著性。否则,使用t检验。1期患者累积每月就诊分布在4月达到峰值(高于平均水平108%),在10月、11月和12月最低(低于平均水平48%)(p<0.001)。对照组的季节性在5月达到峰值(高于平均水平84%),在8月最低(低于平均水平69%)(p<0.001)。两组内受试者的季节性模式受一些年龄组和两性的影响(p<0.05)。年龄和两性在季节性变化幅度上的一些差异增加了年龄、性别和疾病之间相互作用的可能性。需要进一步设计良好的前瞻性研究,以更好地理解我们研究结果的重要性和疾病的发病机制。