外周动脉疾病与脊髓损伤：一项全国性回顾性队列研究。
Peripheral Arterial Disease and Spinal Cord Injury: A Retrospective Nationwide Cohort Study.
作者信息
Su Ta-Wei, Chou Tzu-Yi, Jou Herng-Jeng, Yang Pei-Yu, Lin Cheng-Li, Sung Fung-Chang, Hsu Chung-Y, Kao Chia-Hung
机构信息
From the Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan (TWS); Department of Physical Medicine and Rehabilitation, China Medical University Hospital (TYC, PYY); Department of Orthopedic Surgery, Kuang Tien General Hospital (HJJ); Department of Nursing, Hungkuang University (HJJ); School of Medicine, China Medical University (PYY, CLL); Management Office for Health Data, China Medical University Hospital (CLL, FCS); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (FCS, CYH, CHK); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (CHK).
出版信息
Medicine (Baltimore). 2015 Oct;94(41):e1655. doi: 10.1097/MD.0000000000001655.
The aim of this study was to elucidate the relationship between spinal cord injury (SCI) and the risk of peripheral arterial disease (PAD) in a cohort study with a large representative sample.The National Health Insurance Database was used to select patients who were diagnosed from 2000 to 2010. Patients with a history of PAD were excluded. The SCI group comprised 42,673 patients diagnosed with SCI, and we enrolled 170,389 matched controls (non-SCI group). We used a Cox proportional hazards regression model to analyze the adjusted risk of PAD between the case and control patients.Patients with SCI exhibited a significantly higher risk (hazard ratio [HR] = 1.37; 95% confidence interval [CI] = 1.22-1.53) of PAD than patients without SCI. Patients with diabetes were at the highest risk of developing PAD (adjusted HR = 3.11, 95% CI = 2.80-3.44). Among patients without comorbidity, SCI patients exhibited a significantly higher risk of PAD than non-SCI patients. Furthermore, lumbar, sacral, or coccygeal spine, and multiple spine SCI were significantly associated with an increased risk of PAD (HR = 1.56, 95% CI = 1.33-1.84, HR = 2.11, 95% CI = 1.59-2.79, respectively).SCI is associated with an increased risk of PAD. Future studies should focus on modifying risk factors to reduce PAD risk among patients with SCI.
本研究的目的是在一项具有大型代表性样本的队列研究中阐明脊髓损伤（SCI）与外周动脉疾病（PAD）风险之间的关系。利用国民健康保险数据库选择2000年至2010年期间被诊断的患者。排除有PAD病史的患者。SCI组包括42673例被诊断为SCI的患者，我们纳入了170389例匹配对照（非SCI组）。我们使用Cox比例风险回归模型分析病例组和对照组患者发生PAD的校正风险。与无SCI的患者相比，SCI患者发生PAD的风险显著更高（风险比[HR]=1.37；95%置信区间[CI]=1.22-1.53）。糖尿病患者发生PAD的风险最高（校正HR=3.11，95%CI=2.80-3.44）。在无合并症的患者中，SCI患者发生PAD的风险显著高于非SCI患者。此外，腰椎、骶骨或尾骨脊柱损伤以及多节段脊柱SCI与PAD风险增加显著相关（HR分别为1.56，95%CI=1.33-1.84；HR为2.11，95%CI=1.59-2.79）。SCI与PAD风险增加相关。未来的研究应集中于改变风险因素，以降低SCI患者发生PAD的风险。
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