Uppsala University Hospital, Department of Orthopaedics, SE-75185 Uppsala, Sweden.
Pediatrics. 2010 Jun;125(6):e1308-15. doi: 10.1542/peds.2009-2935. Epub 2010 May 3.
We hypothesized that patients with Legg-Calvé-Perthes disease (LCPD) might have higher risks of cardiovascular and blood diseases.
A total of 3141 patients, 2 to 15 years of age, with LCPD diagnosed between 1965 and 2005 were identified with the Swedish Inpatient Register. A total of 15 595 individuals without LCPD were selected randomly from among the Swedish general population, with matching according to year of birth, age, gender, and region of residence. Cox proportional-hazard regression analyses, with adjustment for socioeconomic index, were used to estimate relative risks. The patients also were compared with their same-gender siblings.
Patients with LCPD had a hazard ratio (HR) of 1.70 (95% confidence interval [CI]: 1.39-2.09) for cardiovascular diseases, compared with individuals without LCPD. The point estimate was slightly higher among subjects >30 years of age at the follow-up (HR: 2.10 [95% CI: 1.52-2.91]). There were statistically significantly higher risks for blood diseases, including anemias and coagulation defects (HR: 1.41 [95% CI: 1.07-1.86]), which were more pronounced among subjects >30 years of age at the follow-up (HR: 2.70 [95% CI: 1.50-4.84]). Patients also had statistically significantly higher risks of hypertensive disease (HR: 2.97 [95% CI: 1.87-4.72]) and nutritional anemia (HR: 2.92 [95% CI: 1.58-5.40]). Analyses using siblings as the comparison group showed consistent results for cardiovascular diseases.
The results are consistent with the hypothesis that an insufficient blood supply to the femoral head, attributable to vascular pathologic conditions, is involved in the pathogenesis of LCPD.
我们假设莱格-卡维-佩尔特斯病(LCPD)患者可能存在更高的心血管和血液疾病风险。
共纳入 3141 例 1965 年至 2005 年期间被诊断为 LCPD 的 2 至 15 岁患者,这些患者均来自瑞典住院患者登记库。同时,还从瑞典普通人群中随机选择了 15595 例无 LCPD 的个体作为对照,匹配其出生年份、年龄、性别和居住地区。使用 Cox 比例风险回归分析,并调整社会经济指数,来估计相对风险。同时,我们还将患者与他们的同性别兄弟姐妹进行了比较。
与无 LCPD 的个体相比,LCPD 患者的心血管疾病发病风险比为 1.70(95%置信区间:1.39-2.09)。在随访时年龄大于 30 岁的患者中,这一数值略有升高(HR:2.10[95%CI:1.52-2.91])。此外,LCPD 患者还存在更高的血液疾病发病风险,包括贫血和凝血缺陷(HR:1.41[95%CI:1.07-1.86]),在随访时年龄大于 30 岁的患者中,这种风险更为显著(HR:2.70[95%CI:1.50-4.84])。LCPD 患者还存在更高的高血压发病风险(HR:2.97[95%CI:1.87-4.72])和营养性贫血发病风险(HR:2.92[95%CI:1.58-5.40])。采用兄弟姐妹作为对照组进行的分析结果显示,心血管疾病的结果一致。
这些结果与血管病理条件导致股骨头血供不足与 LCPD 发病机制相关的假说一致。