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2100例IgA缺乏症患者的感染风险:一项全国性队列研究

Risk of Infections Among 2100 Individuals with IgA Deficiency: a Nationwide Cohort Study.

作者信息

Ludvigsson Jonas F, Neovius Martin, Hammarström Lennart

机构信息

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Department of Paediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden.

出版信息

J Clin Immunol. 2016 Feb;36(2):134-40. doi: 10.1007/s10875-015-0230-9. Epub 2016 Jan 6.

Abstract

PURPOSE

To explore the risk of infections in individuals with IgA deficiency compared to general population controls.

METHODS

In this nationwide prospective population-based cohort study, we used data on IgA levels (<0.07 g/L) from six university hospitals in Sweden to identify 2100 individuals with IgA deficiency. Individuals were diagnosed between 1980 and 2010. For each patient with IgA deficiency we identified 10 controls from the general population, matched on age, sex, and place of residence (n = 18,653). Data on infections were obtained from the Swedish National Patient Register (including inpatient and hospital-based outpatient care) between 2001 and 2010. We defined infections as having a record of a relevant international classification of disease (ICD) code. Prevalences and prevalence ratios (PRs) were calculated.

RESULTS

Individuals with IgA deficiency were more likely to have a record of any infection (36.1 vs. 18.8% in controls) corresponding to a PR of 2.4 (95%CI 2.2-2.6). We also noted statistically significant associations with IgA deficiency (all P-values <0.05) and respiratory tract infections (17.8 vs. 6.3% in controls; PR = 3.2), gastrointestinal infections (6.0 vs. 1.8% in controls; PR = 3.5), skin infections (4.1 vs. 2.2% in controls; PR = 1.9), joint infections (0.48 vs. 0.24% in controls; PR = 2.0; P = 0.052), sepsis (1.5 vs. 0.45% in controls; PR = 3.4), meningitis (0.38 vs. 0.12%, PR = 3.2), mastoiditis/otitis (2.1 vs. 1.1% in controls; PR = 2.0), and urinary tract infections (6.1 vs. 3.4% in controls; PR = 1.8).

CONCLUSIONS

Individuals with IgA deficiency are at an increased risk of infections requiring hospital care.

摘要

目的

探讨与普通人群对照相比,IgA缺乏个体的感染风险。

方法

在这项全国性的基于人群的前瞻性队列研究中,我们使用了瑞典六所大学医院的IgA水平(<0.07 g/L)数据来识别2100名IgA缺乏个体。个体在1980年至2010年期间被诊断。对于每例IgA缺乏患者,我们从普通人群中确定10名对照,根据年龄、性别和居住地点进行匹配(n = 18,653)。2001年至2010年期间,感染数据来自瑞典国家患者登记处(包括住院和医院门诊护理)。我们将感染定义为有相关国际疾病分类(ICD)代码记录。计算患病率和患病率比(PRs)。

结果

IgA缺乏个体更有可能有任何感染记录(36.1%对对照组的18.8%),对应PR为2.4(95%CI 2.2 - 2.6)。我们还注意到与IgA缺乏存在统计学显著关联(所有P值<0.05)以及呼吸道感染(17.8%对对照组的6.3%;PR = 3.2)、胃肠道感染(6.0%对对照组的1.8%;PR = 3.5)、皮肤感染(4.1%对对照组的2.2%;PR = 1.9)、关节感染(0.48%对对照组的0.24%;PR = 2.0;P = 0.052)、败血症(1.5%对对照组的0.45%;PR = 3.4)、脑膜炎(0.38%对0.12%,PR = 3.2)、乳突炎/中耳炎(2.1%对对照组的1.1%;PR = 2.0)和尿路感染(6.1%对对照组的3.4%;PR = 1.8)。

结论

IgA缺乏个体需要住院治疗的感染风险增加。

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