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慢性牙周炎及其治疗对随后发生银屑病的影响。

The effects of chronic periodontitis and its treatment on the subsequent risk of psoriasis.

机构信息

School of Public Health, Taipei Medical University, Taipei, Taiwan.

出版信息

Br J Dermatol. 2012 Dec;167(6):1338-44. doi: 10.1111/j.1365-2133.2012.11126.x. Epub 2012 Sep 27.

Abstract

BACKGROUND

Although psoriasis and chronic periodontitis (CP) may share an underlying immune dysregulation as part of their pathologies, to date only one small-scale cross-sectional pilot study has investigated the potential association between CP and psoriasis.

OBJECTIVES

This study aimed to investigate the subsequent risk for psoriasis following a diagnosis of CP by utilizing a cohort study design and population-based dataset in Taiwan.

METHODS

In total, 115 365 patients with CP were included in the study cohort and 115 365 patients without CP were included in the comparison cohort. We individually tracked each patient for a 5-year period to identify those who had subsequently received a diagnosis of psoriasis. A Cox proportional hazards regression was performed to compute the 5-year risk of subsequent psoriasis following a diagnosis of CP.

RESULTS

We found that the incidence rate of psoriasis during the 5-year follow-up period was 1·88 [95% confidence interval (CI) 1·77-1·99] per 1000 person-years in patients with CP and 1·22 (95% CI 1·14-1·32) per 1000 person-years in comparison patients. After censoring those who died during the follow-up period, and adjusting for monthly income and geographical region, compared with comparison patients, the hazard ratio (HR) of psoriasis for patients with CP was 1·52 (95% CI 1·38-1·70). Furthermore, the study subjects who had undergone a gingivectomy or periodontal flap operation had only a slightly higher adjusted risk of psoriasis than comparison patients (HR 1·26).

CONCLUSIONS

This study detected an increased risk for psoriasis among patients with CP. Treatment for CP attenuated, but did not nullify, the risk for subsequent psoriasis.

摘要

背景

尽管银屑病和慢性牙周炎(CP)可能在其病理过程中存在共同的免疫失调,但迄今为止,仅有一项小规模横断面试点研究调查了 CP 与银屑病之间的潜在关联。

目的

本研究旨在通过队列研究设计和基于人群的台湾数据集,调查 CP 诊断后银屑病的后续发病风险。

方法

共纳入 115365 例 CP 患者作为研究队列,纳入 115365 例无 CP 患者作为对照队列。我们对每位患者进行了 5 年的个体跟踪,以确定随后被诊断为银屑病的患者。采用 Cox 比例风险回归计算 CP 诊断后 5 年内银屑病的后续发病风险。

结果

我们发现,在 5 年随访期间,CP 患者的银屑病发病率为 1.88(95%置信区间 1.77-1.99)/1000 人年,而对照患者的发病率为 1.22(95%置信区间 1.14-1.32)/1000 人年。在随访期间死亡的患者被删节后,调整月收入和地理位置因素后,与对照患者相比,CP 患者的银屑病风险比(HR)为 1.52(95%置信区间 1.38-1.70)。此外,接受牙龈切除术或牙周翻瓣术的研究对象发生银屑病的调整后风险仅略高于对照患者(HR 1.26)。

结论

本研究发现 CP 患者银屑病发病风险增加。CP 的治疗降低了但未消除随后发生银屑病的风险。

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