系统性硬皮病增加深静脉血栓和肺血栓栓塞症的风险：一项全国性队列研究。
Systemic sclerosis increases the risks of deep vein thrombosis and pulmonary thromboembolism: a nationwide cohort study.
机构信息
Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Management Office for Health Data, China Medical University Hospital, Department of Public Health, China Medical University and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Management Office for Health Data, China Medical University Hospital, Department of Public Health, China Medical University and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Management Office for Health Data, China Medical University Hospital, Department of Public Health, China Medical University and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
出版信息
Rheumatology (Oxford). 2014 Sep;53(9):1639-45. doi: 10.1093/rheumatology/keu133. Epub 2014 Apr 8.
OBJECTIVES
Few Asian studies have evaluated the risks of deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) in patients with SSc. We conducted a nationwide population-based cohort study to evaluate how SSc affected the incidence of DVT and PTE in Taiwan.
METHODS
We identified patients with an SSc diagnosis in Taiwan between 1998 and 2010 using the Catastrophic Illness Patient Database and the National Health Insurance Research Database. Each SSc patient was frequency matched to four control patients based on age, sex and index year and all patients were observed from the index date until the appearance of a DVT or PTE event or 31 December 2010. We calculated the hazard ratios and 95% CIs of DVT and PTE in the SSc and comparison cohorts using the Cox proportional hazards regression model.
RESULTS
We observed 1895 SSc patients and 7580 control patients for ∼10,128 and 46,488 person-years, respectively. The mean ages of the SSc and comparison cohorts were 50.3 and 49.9 years, respectively. After adjusting for age, sex and co-morbidities, the risks of DVT and PTE among the SSc patients were 10.5- and 7.00-fold higher than those of the control patients. The probability of developing DVT and PTE increased in the years following the SSc diagnosis.
CONCLUSION
SSc patients exhibited a significantly higher risk of developing DVT and PTE compared with the general population. Thus multidisciplinary teams should guide the assessment, treatment and holistic care of SSc patients.
目的
鲜有亚洲研究评估过系统性硬化症（SSc）患者发生深静脉血栓（DVT）和肺血栓栓塞症（PTE）的风险。我们开展了一项全国性基于人群的队列研究，以评估 SSc 如何影响台湾 DVT 和 PTE 的发病情况。
方法
我们使用灾难性疾病患者数据库和全民健康保险研究数据库，于 1998 年至 2010 年间在台湾识别出 SSc 患者。根据年龄、性别和索引年度，每位 SSc 患者与 4 名对照患者进行频数匹配，所有患者从索引日期开始随访，直至出现 DVT 或 PTE 事件或 2010 年 12 月 31 日。我们使用 Cox 比例风险回归模型计算 SSc 和对照组中 DVT 和 PTE 的风险比（HR）及其 95%置信区间（CI）。
结果
我们观察了 1895 例 SSc 患者和 7580 例对照患者，分别随访了约 10128 人和 46488 人年。SSc 和对照组的平均年龄分别为 50.3 岁和 49.9 岁。在调整年龄、性别和合并症后，SSc 患者发生 DVT 和 PTE 的风险分别是对照组的 10.5 倍和 7.00 倍。在 SSc 诊断后的几年内，发生 DVT 和 PTE 的概率增加。
结论
与一般人群相比，SSc 患者发生 DVT 和 PTE 的风险显著增加。因此，多学科团队应指导 SSc 患者的评估、治疗和整体护理。
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