川崎病与自闭症之间的关联：一项基于台湾人群的研究。
Association between Kawasaki disease and autism: a population-based study in Taiwan.
作者信息
Kuo Ho-Chang, Wu Chung-Min, Chang Wei-Pin, Kuo Chun-Nan, Yeter Deniz, Lin Chun-Yi, Pai Jei-Tsung, Chi Ying-Chen, Lin Chia-Hsien, Wang Liang-Jen, Chang Wei-Chiao
机构信息
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Department of Business Management, National Taipei University of Technology, Taipei 106, Taiwan.
出版信息
Int J Environ Res Public Health. 2014 Apr 3;11(4):3705-16. doi: 10.3390/ijerph110403705.
OBJECTIVE
The association between Kawasaki disease and autism has rarely been studied in Asian populations. By using a nationwide Taiwanese population-based claims database, we tested the hypothesis that Kawasaki disease may increase the risk of autism in Taiwan.
MATERIALS AND METHODS
Our study cohort consisted of patients who had received the diagnosis of Kawasaki disease (ICD-9-CM: 446.1) between 1997 and 2005 (N = 563). For a comparison cohort, five age- and gender-matched control patients for every patient in the study cohort were selected using random sampling (N = 2,815). All subjects were tracked for 5 years from the date of cohort entry to identify whether they had developed autism (ICD-9-CM code 299.0) or not. Cox proportional hazard regressions were then performed to evaluate 5-year autism-free survival rates.
RESULTS
The main finding of this study was that patients with Kawasaki disease seem to not be at increased risk of developing autism. Of the total patients, four patients developed autism during the 5-year follow-up period, among whom two were Kawasaki disease patients and two were in the comparison cohort. Further, the adjusted hazard ratios (AHR) (AHR: 4.81; 95% confidence interval: 0.68-34.35; P = 0.117) did not show any statistical significance between the Kawasaki disease group and the control group during the 5-year follow-up.
CONCLUSION
Our study indicated that patients with Kawasaki disease are not at increased risk of autism.
目的
在亚洲人群中，川崎病与自闭症之间的关联鲜有研究。通过使用一个基于全台湾人群的医保理赔数据库，我们检验了川崎病可能增加台湾地区自闭症风险这一假说。
材料与方法
我们的研究队列由1997年至2005年间被诊断为川崎病（国际疾病分类第九版临床修订本：446.1）的患者组成（N = 563）。对于对照队列，采用随机抽样的方法，为研究队列中的每位患者选取5名年龄和性别匹配的对照患者（N = 2815）。从队列进入日期开始，对所有受试者进行5年的跟踪，以确定他们是否患出自闭症（国际疾病分类第九版临床修订本编码299.0）。然后进行Cox比例风险回归分析，以评估5年无自闭症生存率。
结果
本研究的主要发现是，川崎病患者患自闭症的风险似乎并未增加。在所有患者中，有4名患者在5年随访期内患出自闭症，其中2名是川崎病患者，2名在对照队列中。此外，在5年随访期间，川崎病组和对照组之间的调整后风险比（AHR）（AHR：4.81；95%置信区间：0.68 - 34.35；P = 0.117）没有显示出任何统计学意义。
结论
我们的研究表明，川崎病患者患自闭症的风险并未增加。
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