重症肌无力中的肺结核。

Tuberculosis in myasthenia gravis.

机构信息

Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

Int J Tuberc Lung Dis. 2013 Jan;17(1):79-84. doi: 10.5588/ijtld.12.0260.

DOI:10.5588/ijtld.12.0260

PMID:23232007

Abstract

SETTING

The relationship between myasthenia gravis (MG) and tuberculosis (TB) has not been determined.

OBJECTIVE

To evaluate the relationship between MG and TB.

DESIGN

A national survey conducted between 2000 and 2006 included 2317 patients with MG identified from the Taiwan National Health Insurance database. The incidence rate ratio of TB in these patients was compared with those in 23 170 randomly selected age-, sex- and comorbidity-matched controls without MG.

RESULTS

The risk of TB was higher in the MG cohort (adjusted hazard ratio [aHR] 1.96, 95% confidence interval [CI] 1.22-3.16, P = 0.005), mainly due to an excess risk of pulmonary TB (aHR 2.10, 95%CI 1.27-3.47, P = 0.004). Age ≥60 years (HR 4.99, 95%CI 2.06-12.10, P < 0.001) and the use of corticosteroids (HR 1.12, 95%CI 1.07-1.17, P < 0.001) were risk factors for developing TB in the MG cohort. Patients with MG who developed TB had a lower 5-year survival rate than those who did not (89.4% vs. 96.0%, P = 0.032).

CONCLUSION

The incidence of pulmonary TB is significantly higher in patients with MG. Careful screening strategies for TB should be considered among high-risk patients with MG.

摘要

背景

重症肌无力（MG）与结核病（TB）之间的关系尚未确定。

目的

评估 MG 与 TB 之间的关系。

设计

一项于 2000 年至 2006 年期间开展的全国性调查，纳入了从台湾全民健康保险数据库中确定的 2317 例 MG 患者。将这些患者的 TB 发病率比值与 23170 例年龄、性别和合并症相匹配且无 MG 的随机对照者进行比较。

结果

MG 组的 TB 风险更高（校正后风险比[aHR] 1.96，95%置信区间[CI] 1.22-3.16，P = 0.005），主要是由于肺部 TB 的风险增加（aHR 2.10，95%CI 1.27-3.47，P = 0.004）。年龄≥60 岁（HR 4.99，95%CI 2.06-12.10，P < 0.001）和使用皮质类固醇（HR 1.12，95%CI 1.07-1.17，P < 0.001）是 MG 组发生 TB 的危险因素。发生 TB 的 MG 患者的 5 年生存率低于未发生 TB 的患者（89.4%比 96.0%，P = 0.032）。