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被诊断为慢性骨髓炎的患者患癫痫的风险增加。

Increased risk of epilepsy among patients diagnosed with chronic osteomyelitis.

作者信息

Tseng Chun-Hung, Huang Wei-Shih, Muo Chih-Hsin, Kao Chia-Hung

机构信息

Department of Neurology, China Medical University Hospital, Taichung 40447, Taiwan; School of Medicine, China Medical University, College of Medicine, Taichung 40402, Taiwan.

Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan.

出版信息

Epilepsy Res. 2014 Oct;108(8):1427-34. doi: 10.1016/j.eplepsyres.2014.06.022. Epub 2014 Jul 5.

Abstract

PURPOSE

Inflammatory processes, which raise the unsteadiness of brain neuron membrane potentials, might enhance the development of epilepsy. Inflammation is a substantial indicator of epilepsy risk. In this study, we evaluated whether chronic osteomyelitis (COM), a chronic inflammatory disease, increases epilepsy risk.

MATERIALS AND METHODS

A Taiwanese national insurance claims dataset of more than 22 million enrollees was used to select 20,996 COM patients and 83,973 randomly selected age- and gender-matched controls to investigate epilepsy development over an 11-year follow-up period, starting on January 1, 2000 and ending on December 31, 2010. The epilepsy risk was analyzed using a Cox proportional hazards regression model.

RESULTS

Comorbidities known to elevate epilepsy risk, including diabetes, hypertension, head injury, stroke, and cancer, were commonly noted in the COM cohort, which had considerably higher risk of epilepsy than did the control group. Comparing only those without comorbidities, COM patients still exhibited higher epilepsy risk than the control group did (adjusted hazard ratio [aHR]=3.87, 95% confidence interval [CI]: 3.01-4.98). The younger population exhibited an even greater risk (age ≤39 years: aHR=6.10, 95% CI: 4.00-9.30; age ≥65 years: aHR=1.66, 95% CI: 1.28-2.16).

CONCLUSION

This is the first study linking COM to an increased risk in epilepsy development. The results demonstrated that COM is a significant predictor of epilepsy. Further study of COM patients, particularly young patients, is recommended to facilitate epilepsy prevention.

摘要

目的

炎症过程会增加脑神经元膜电位的不稳定性,可能会促进癫痫的发展。炎症是癫痫风险的一个重要指标。在本研究中,我们评估了慢性炎症性疾病慢性骨髓炎(COM)是否会增加癫痫风险。

材料与方法

使用一个包含超过2200万参保人的台湾国民健康保险理赔数据集,选取20996例COM患者和83973例随机选择的年龄及性别匹配的对照,以调查在2000年1月1日至2010年12月31日的11年随访期内癫痫的发生情况。使用Cox比例风险回归模型分析癫痫风险。

结果

COM队列中常见已知会增加癫痫风险的合并症,包括糖尿病、高血压、头部损伤、中风和癌症,该队列的癫痫风险明显高于对照组。仅比较那些无合并症的患者,COM患者的癫痫风险仍高于对照组(调整后风险比[aHR]=3.87,95%置信区间[CI]:3.01 - 4.98)。较年轻人群的风险更高(年龄≤39岁:aHR=6.10,95%CI:4.00 - 9.30;年龄≥65岁:aHR=1.66,95%CI:1.28 - 2.16)。

结论

这是第一项将COM与癫痫发展风险增加联系起来的研究。结果表明COM是癫痫的一个重要预测指标。建议对COM患者,尤其是年轻患者进行进一步研究,以促进癫痫的预防。

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