一项大规模研究表明，包括类风湿关节炎在内的具有不同风险因素的患者患癫痫的风险增加。
A Large-Scale Study Indicates Increase in the Risk of Epilepsy in Patients With Different Risk Factors, Including Rheumatoid Arthritis.
作者信息
Chang Kuang-Hsi, Hsu Yi-Chao, Chang Mei-Yin, Lin Cheng-Li, Wu Trong-Neng, Hwang Bing-Fang, Chen Chiu-Ying, Liu Hui-Chuan, Kao Chia-Hung
机构信息
From the Department of Public Health, China Medical University, Taichung, Taiwan (K-HC, C-YC); Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (K-HC); Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan (K-HC), Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan (Y-CH); Department of Medical Laboratory Science and Biotechnology, School of Medical and Health Sciences, Fooyin University, Kaohsiung, Taiwan (M-YC); Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan (C-LL); College of Medicine, China Medical University, Taichung, Taiwan (C-LL); Department of Nursing, Hung Kuang University, Taichung, Taiwan (T-NW); Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan (B-FH); Respiratory Therapy Intensive Care Unit, Veterans General Hospital, Taichung, Taiwan (H-CL); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (C-HK); Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
出版信息
Medicine (Baltimore). 2015 Sep;94(36):e1485. doi: 10.1097/MD.0000000000001485.
Peripheral neuropathy and inflammatory reactions of the central nervous system may accompany rheumatoid arthritis (RA). Inflammatory processes play a critical role in epilepsy. Therefore, we conducted this study to determine the risk of epilepsy in patients with RA.The RA cohort comprised patients ages 20 years and older who were newly diagnosed with RA between 2000 and 2011, with data obtained from the Registry of Catastrophic Illnesses Patient Database. Patients without RA were frequency matched with an RA cohort at a 1:1 ratio according to age, sex, and year of RA diagnosis.The overall crude hazard ratio (HR) for epilepsy was 1.27-fold higher in the RA cohort compared with that in the controls. After adjustment for age, sex, comorbidities, and medications, the patients with RA were associated with an increased risk of epilepsy compared with those without RA (adjusted HR [aHR] = 1.52, 95% confidence interval [CI] = 1.12-2.07). Compared with the RA patients with ≤ 560 days of nonsteroidal anti-inflammatory drug (NSAID) use, the RA patients with 1181 to 2145 and >2145 days of NSAID use had a significantly lower risk of epilepsy (aHR = 0.35, 95% CI = 0.24-0.52 and aHR = 0.15, 95% CI = 0.09-0.24, respectively).This study provides compelling evidence of an increased risk of epilepsy in patients with RA. The period of NSAID treatment is negatively associated with the risk of epilepsy in RA patients.
周围神经病变和中枢神经系统炎症反应可能伴随类风湿性关节炎（RA）出现。炎症过程在癫痫中起关键作用。因此，我们开展了这项研究以确定RA患者患癫痫的风险。RA队列包括20岁及以上在2000年至2011年间新诊断为RA的患者，数据来自重大疾病患者数据库登记处。无RA的患者根据年龄、性别和RA诊断年份与RA队列以1:1的比例进行频率匹配。RA队列中癫痫的总体粗风险比（HR）比对照组高1.27倍。在对年龄、性别、合并症和药物进行调整后，与无RA的患者相比，RA患者患癫痫的风险增加（调整后HR [aHR]=1.52，95%置信区间[CI]=1.12 - 2.07）。与使用非甾体抗炎药（NSAID）≤560天的RA患者相比，使用NSAID 1181至2145天和>2145天的RA患者患癫痫的风险显著更低（aHR分别为0.35，95% CI=0.24 - 0.52和aHR为0.15，95% CI=0.09 - 0.24）。这项研究提供了令人信服的证据，证明RA患者患癫痫的风险增加。NSAID治疗时间与RA患者患癫痫的风险呈负相关。
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