Taichung Hospital, Ministry of Health and Welfare, Taichung.
Eur Respir J. 2014 Mar;43(3):801-7. doi: 10.1183/09031936.00043313. Epub 2013 Aug 29.
Studies on the association between asthma and pulmonary thromboembolism are considerably limited. We investigated whether pulmonary embolism is associated with asthma using a nationwide cohort study. We identified 31,356 patients with newly diagnosed asthma in 2002-2008 and 125,157 individuals without asthma randomly selected from the general population, frequency matched by age, sex and index year using the National Health Insurance Research Database. Both cohorts were followed-up until the end of 2010 to measure the incidence of pulmonary embolism. Cox proportional hazards regression analysis was used to measure the hazard ratio of pulmonary embolism for the asthmatic cohort, compared with the nonasthmatic cohort. We followed 186,182 person-years for asthmatic patients and 743,374 person-years for nonasthmatic subjects. The hazard ratio of pulmonary embolism was 3.24 for the asthmatic cohort, compared with the nonasthmatic cohort after adjusting for sex, age, comorbidities and oestrogen supplementation. The risk of developing pulmonary embolism significantly increased with the increased frequency of asthma exacerbation and hospitalisation. This nationwide cohort study suggests that the risk of developing pulmonary embolism is significantly increased in asthmatic patients compared to the general population. Frequent asthma exacerbation and hospitalisation are significantly associated with pulmonary embolism risk.
哮喘与肺血栓栓塞症之间的相关性研究相当有限。我们使用全国性队列研究调查了肺栓塞是否与哮喘有关。我们从国家健康保险研究数据库中识别出 2002 年至 2008 年间新诊断为哮喘的 31356 例患者和随机选择的 125157 例无哮喘个体,通过年龄、性别和指数年进行频数匹配。两个队列均随访至 2010 年底,以测量肺栓塞的发病率。使用 Cox 比例风险回归分析测量哮喘队列与非哮喘队列的肺栓塞风险比。我们对哮喘患者进行了 186182 人年的随访,对非哮喘患者进行了 743374 人年的随访。在调整了性别、年龄、合并症和雌激素补充后,哮喘队列的肺栓塞风险比为 3.24。随着哮喘加重和住院的频率增加,发生肺栓塞的风险显著增加。这项全国性队列研究表明,与一般人群相比,哮喘患者发生肺栓塞的风险显著增加。频繁的哮喘加重和住院与肺栓塞风险显著相关。