Mikaeloff Yann, Caridade Guillaume, Suissa Samy, Tardieu Marc
Service de Neurologie Pédiatrique, CHU Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre Cedex, France.
Am J Epidemiol. 2009 May 15;169(10):1260-6. doi: 10.1093/aje/kwp039. Epub 2009 Mar 27.
The authors conducted a population-based case-control study to investigate whether clinically observed chickenpox, linked with a level of intensity for clinical expression, increases the risk of multiple sclerosis (MS) in childhood. The cases were MS patients whose disease onset occurred between 1994 and 2003, before age 16 years, in France. Each case was matched for age, sex, and geographic origin with as many as 12 controls randomly selected from the general population. Information about clinically observed chickenpox in cases and controls before the index date regarding onset of MS was collected with a standardized questionnaire and was checked against health certificates. Conditional logistic regression was used to estimate the odds ratio for an association between MS and chickenpox. The 137 MS cases were matched with 1,061 controls. Clinically observed chickenpox had occurred in 76.6% of the cases and 84.9% of their matched controls. The adjusted odds ratio of MS onset associated with chickenpox occurrence was 0.58 (95% confidence interval: 0.36, 0.92). The authors concluded that clinically observed chickenpox was associated with a lower risk of childhood-onset MS in a French population.
作者开展了一项基于人群的病例对照研究,以调查临床观察到的水痘(与临床症状的严重程度相关)是否会增加儿童患多发性硬化症(MS)的风险。病例为1994年至2003年期间在法国发病且发病年龄在16岁之前的MS患者。每个病例按照年龄、性别和地理来源,与从普通人群中随机选取的多达12名对照进行匹配。通过标准化问卷收集病例和对照在MS发病索引日期之前临床观察到的水痘信息,并与健康证明进行核对。采用条件逻辑回归来估计MS与水痘之间关联的比值比。137例MS病例与1061名对照进行了匹配。76.6%的病例和84.9%与之匹配的对照曾有临床观察到的水痘。水痘发生与MS发病相关的校正比值比为0.58(95%置信区间:0.36,0.92)。作者得出结论,在法国人群中,临床观察到的水痘与儿童期发病的MS风险较低相关。