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慢性阻塞性肺疾病患者患痴呆症的风险增加。

Increased Risk of Dementia in Patients With Chronic Obstructive Pulmonary Disease.

作者信息

Liao Kuang-Ming, Ho Chung-Han, Ko Shian-Chin, Li Chung-Yi

机构信息

From the Department of Internal Medicine, Chi Mei Medical Center, Chiali (K-ML); Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University (K-ML); Department of Medical Research, Chi Mei Medical Center (C-HH); Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science (C-HH); Department of Chest Medicine, Chi Mei Medical Center (S-CK); Department of Public Health, College of Medicine, National Cheng Kung University, Tainan (C-YL); and Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan (C-YL).

出版信息

Medicine (Baltimore). 2015 Jun;94(23):e930. doi: 10.1097/MD.0000000000000930.

Abstract

Neurodegenerative disease in patients with chronic obstructive pulmonary disease (COPD) was observed. We aim to clarify the risk of dementia in patients with COPD. The study used claims data from Taiwan's National Health Insurance Research Database. Subjects were those who received a discharge diagnosis of COPD between January 1, 2002 and December 31, 2011. Only the first hospitalization was enrolled, and the index date was the first day of admission. Patients younger than 40 years or those with a history of Alzheimer disease (AD) or Parkinson disease (PD) before the index date were excluded. The patients with COPD were then followed until receiving a diagnosis of AD or PD, death, or the end of the study. Control subjects were selected from hospitalized patients without a history of COPD, AD, or PD and were matched according to age (±3 years), gender, and the year of admission at a 2:1 ratio. The comorbidities were measured from 1 year before the index date based on the ICD-9-CM codes. The study included 8640 patients with COPD and a mean age of 68.76 (±10.74) years. The adjusted hazard ratio of developing dementia (AD or PD) was 1.74 (95% confidence interval = 1.55-1.96) in patients with COPD compared with patients without COPD after adjusting for age, gender, and comorbidities. This nationwide cohort study demonstrates that the risk of dementia, including AD and PD, is significantly increased in patients with COPD compared with individuals in the general population.

摘要

观察到慢性阻塞性肺疾病(COPD)患者存在神经退行性疾病。我们旨在阐明COPD患者患痴呆症的风险。该研究使用了台湾国民健康保险研究数据库中的理赔数据。研究对象为在2002年1月1日至2011年12月31日期间出院诊断为COPD的患者。仅纳入首次住院病例,索引日期为入院首日。排除年龄小于40岁或在索引日期之前有阿尔茨海默病(AD)或帕金森病(PD)病史的患者。然后对COPD患者进行随访,直至诊断为AD或PD、死亡或研究结束。对照对象从无COPD、AD或PD病史的住院患者中选取,并根据年龄(±3岁)、性别和入院年份以2:1的比例进行匹配。根据国际疾病分类第九版临床修订本(ICD - 9 - CM)编码,从索引日期前1年开始测量合并症。该研究纳入了8640例COPD患者,平均年龄为68.76(±10.74)岁。在调整年龄、性别和合并症后,COPD患者发生痴呆症(AD或PD)的调整后风险比为1.74(95%置信区间 = 1.55 - 1.96),与无COPD的患者相比。这项全国性队列研究表明,与一般人群相比,COPD患者患包括AD和PD在内的痴呆症的风险显著增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36b3/4616489/a632887204f1/medi-94-e930-g004.jpg

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