Chiu Chun-Hsiang, Lin Cheng-Li, Lee Feng-You, Wang Ying-Chuan, Kao Chia-Hung
From the Division of Infectious Diseases and Tropical Medicine (C-HC), Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center; Institute of Clinical Medicine (C-HC), School of Medicine, National Yang-Ming University; Management Office for Health Data (C-LL), China Medical University Hospital; College of Medicine, China Medical University(C-LL); Department of Emergency Medicine (F-YL), Taichung Tzu Chi Hospital, Taichung; Department of Family Medicine (Y-CW), Tri-Service General Hospital, National Defense Medical Center; Graduate Institute of Clinical Medical Science and School of Medicine (C-HK), College of Medicine, China Medical University; and Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital, Taichung, Taiwan.
Medicine (Baltimore). 2016 Mar;95(11):e3127. doi: 10.1097/MD.0000000000003127.
Data on the association between peripheral artery occlusive disease (PAOD) and leptospirosis are limited. We conducted a retrospective cohort study for determining whether leptospirosis is one of the possible risk factors for PAOD. Patients diagnosed with leptospirosis by using 2000 to 2010 data from the Taiwan National Health Insurance Research Database. Patients with leptospirosis without a history of PAOD were selected. For each leptospirosis patient, 4 controls without a history of leptospirosis and PAOD were randomly selected and frequency-matched for sex, age, the year of the index date, and comorbidity diseases. The follow-up period was from the time of the initial diagnosis of leptospirosis to the diagnosis date of PAOD, or December 31, 2011. The Cox proportional hazard regression models were used for analyzing the risk of PAOD. During the follow-up period, the cumulative incidence of PAOD was higher among the patients from the leptospirosis cohort than among the nonleptospirosis cohort (log-rank test, P < 0.001). In total, 29 patients with PAOD from the leptospirosis cohort and 81 from the nonleptospirosis cohort were observed with the incidence rates of 2.1 and 1.3 per 1000 person-years, respectively, yielding a crude hazards ratio (HR) of 1.62 (95% confidence interval [CI] = 1.44-1.81) and adjusted HR (aHR) of 1.75 (95% CI = 1.58-1.95).The risk of PAOD was 1.75-fold higher in the patients with leptospirosis than in the general population.
关于外周动脉闭塞性疾病（PAOD）与钩端螺旋体病之间关联的数据有限。我们进行了一项回顾性队列研究，以确定钩端螺旋体病是否为PAOD的可能危险因素之一。利用台湾国民健康保险研究数据库2000年至2010年的数据诊断出患有钩端螺旋体病的患者。选择无PAOD病史的钩端螺旋体病患者。对于每位钩端螺旋体病患者，随机选择4名无钩端螺旋体病和PAOD病史的对照，并按性别、年龄、索引日期年份和合并症进行频率匹配。随访期从钩端螺旋体病初次诊断时间至PAOD诊断日期或2011年12月31日。采用Cox比例风险回归模型分析PAOD风险。在随访期间，钩端螺旋体病队列患者中PAOD的累积发病率高于非钩端螺旋体病队列患者（对数秩检验，P<0.001）。总共观察到钩端螺旋体病队列中有29例PAOD患者，非钩端螺旋体病队列中有81例，发病率分别为每1000人年2.1例和1.3例，粗风险比（HR）为1.62（95%置信区间[CI]=1.44-1.81），调整后HR（aHR）为1.75（95%CI=1.58-1.95）。钩端螺旋体病患者发生PAOD的风险比一般人群高1.75倍。
Zotero 插件