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14000例乳糜泻患者的血栓栓塞风险

Risk of thromboembolism in 14,000 individuals with coeliac disease.

作者信息

Ludvigsson Jonas F, Welander Adina, Lassila Riitta, Ekbom Anders, Montgomery Scott M

机构信息

Department of Paediatrics, Orebro University Hospital, and Department of Medicine, Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.

出版信息

Br J Haematol. 2007 Oct;139(1):121-7. doi: 10.1111/j.1365-2141.2007.06766.x.

Abstract

The risk of venous thromboembolism (VTE) was examined in individuals with coeliac disease (CD). The Swedish national inpatient register was used to identify 14 207 individuals with a diagnosis of CD (1964-2003). These individuals were matched for age, sex, calendar year and county with 69 048 reference individuals. Cox regression was used to estimate hazard ratios (HRs) for subsequent thromboembolism in individuals with more than 1 year of follow-up and no prior VTE. CD was associated with an increased risk of subsequent VTE (HR = 1.86; 95% confidence interval (CI) 1.54-2.24). The risk increase was restricted to individuals with CD diagnosed in adulthood. Risk estimates were not affected by the presence of diabetes mellitus or concomitant surgery. Compared with inpatients as reference individuals, CD individuals remained at increased risk of subsequent VTE (adjusted HR = 1.27; 95% CI = 1.06-1.52). In conclusion, this study found a statistically significantly positive association between CD and VTE. This modest association might be explained by a combination of surveillance bias and chronic inflammation.

摘要

对患有乳糜泻(CD)的个体的静脉血栓栓塞(VTE)风险进行了研究。瑞典国家住院患者登记册用于识别14207名诊断为CD的个体(1964 - 2003年)。这些个体在年龄、性别、日历年和郡县方面与69048名对照个体进行匹配。采用Cox回归来估计随访超过1年且无既往VTE的个体发生后续血栓栓塞的风险比(HRs)。CD与后续VTE风险增加相关(HR = 1.86;95%置信区间(CI)1.54 - 2.24)。风险增加仅限于成年期诊断为CD的个体。风险估计不受糖尿病或同期手术的影响。与住院患者作为对照个体相比,CD个体发生后续VTE的风险仍然增加(校正HR = 1.27;95% CI = 1.06 - 1.52)。总之,本研究发现CD与VTE之间存在统计学上显著的正相关。这种适度的关联可能由监测偏倚和慢性炎症共同解释。

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