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经常进行经皮冠状动脉介入治疗的心脏病专家的癌症风险:一项基于人群的研究。

Risk of cancer among cardiologists who frequently perform percutaneous coronary interventions: a population-based study.

机构信息

Department of Radiology, China Medical University Hospital, Taichung, Taiwan.

School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.

出版信息

Eur J Clin Invest. 2016 Jun;46(6):527-34. doi: 10.1111/eci.12628. Epub 2016 Apr 15.

Abstract

BACKGROUND

Cardiologists who frequently perform percutaneous coronary interventions (PCIs) are exposed to high levels of radiation; therefore, their risk of cancer may be higher compared with other internists or cardiologists who perform fewer PCIs.

METHODS

Data were obtained from the Taiwan National Health Insurance Research Database for the 2000-2011 period. A cohort of 542 cardiologists was randomly frequency-matched according to age and sex with four other internists to form a cohort of noncardiologist controls. The incidence of cancer was measured for both cohorts, who were followed up until the end of 2011. Cox proportional hazards models were employed to analyse the risk of cancer between cardiologist and control cohorts.

RESULTS

In general, the cardiologists did not have a higher risk of cancer compared with the other internists. However, the cardiologists who worked in medical centres or regional hospitals had a higher risk of cancer than did the other internists in the same work settings. Furthermore, the cardiologists working in medical centres or regional hospitals (large hospitals) who performed >15 PCIs per year had a higher risk of cancer than did those working in district hospitals (small hospitals) or clinics who performed ≤15 PCIs per year.

CONCLUSION

Cardiologists who frequently perform PCIs have a higher risk of cancer compared with other internists or cardiologists who perform relatively fewer PCIs. Protection from radiation exposure should therefore be emphasized in coronary catheterization laboratories.

摘要

背景

经常进行经皮冠状动脉介入治疗(PCI)的心脏病专家会受到高水平的辐射,因此与进行较少 PCI 的其他内科医生或心脏病专家相比,他们患癌症的风险可能更高。

方法

本研究的数据来自 2000 年至 2011 年期间的台湾全民健康保险研究数据库。根据年龄和性别,将 542 名心脏病专家随机与其他四名内科医生进行频率匹配,组成一组非心脏病专家对照组。对两组患者的癌症发病率进行了测量,并随访至 2011 年底。采用 Cox 比例风险模型分析心脏病专家和对照组之间的癌症风险。

结果

总体而言,心脏病专家患癌症的风险并不高于其他内科医生。然而,在医疗中心或区域医院工作的心脏病专家比在相同工作环境下的其他内科医生患癌症的风险更高。此外,在医疗中心或区域医院(大医院)工作且每年进行 >15 次 PCI 的心脏病专家比在地区医院(小医院)或诊所工作且每年进行 ≤15 次 PCI 的心脏病专家患癌症的风险更高。

结论

与进行相对较少 PCI 的其他内科医生或心脏病专家相比,经常进行 PCI 的心脏病专家患癌症的风险更高。因此,应在冠状动脉导管室强调对辐射暴露的防护。

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