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痛风患者的感染风险:一项基于人群的队列研究。

Risk of infections in patients with gout: a population-based cohort study.

机构信息

Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.

Department of Internal medicine and Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands.

出版信息

Sci Rep. 2017 May 3;7(1):1429. doi: 10.1038/s41598-017-01588-5.

Abstract

To investigate the risk of various types of infections (pneumonia and urinary tract infection (UTI)), and infection-related mortality in patients with gout compared with population-based controls. A retrospective cohort study was conducted using data from the UK Clinical Practice Research Datalink (CPRD). All patients with a first diagnosis of gout and aged >40 years between January 1987-July 2014, were included and matched with up to two controls. Time-varying Cox proportional hazards models were used to estimate the risk of infections and mortality. 131,565 patients and 252,763 controls (mean age: 64 years, 74% males, mean follow-up of 6.7 years) were included in the full cohort. After full statistical adjustment, the risk of pneumonia was increased (adj. HR 1.27, 95% CI 1.18 to 1.36), while the risk of UTI (adj. HR 0.99, 95% CI 0.97 to 1.01) was similar in patients compared to controls. No differences between patients and controls were observed for infection-related mortality due to pneumonia (adj. HR 1.03, 95% CI 0.93 to 1.14) or UTI (adj. HR 1.16, 95% CI 0.98 to 1.37). In conclusion, patients with gout did not have decreased risks of pneumonia, UTI or infection-related mortality compared to population-based controls.

摘要

为了研究与人群对照相比,痛风患者发生各种类型感染(肺炎和尿路感染 (UTI))和感染相关死亡的风险。本研究使用英国临床实践研究数据链 (CPRD) 的数据进行了一项回顾性队列研究。1987 年 1 月至 2014 年 7 月期间,所有年龄>40 岁且首次诊断为痛风的患者均被纳入研究,并与至多 2 名对照相匹配。采用时变 Cox 比例风险模型来估计感染和死亡率的风险。共纳入 131565 名患者和 252763 名对照(平均年龄:64 岁,74%为男性,平均随访 6.7 年)。经过完全统计学调整后,肺炎的发病风险增加(调整后 HR 1.27,95%CI 1.18 至 1.36),而与对照相比,患者发生 UTI 的风险相似(调整后 HR 0.99,95%CI 0.97 至 1.01)。由于肺炎(调整后 HR 1.03,95%CI 0.93 至 1.14)或 UTI(调整后 HR 1.16,95%CI 0.98 至 1.37),患者与对照之间的感染相关死亡率无差异。总之,与人群对照相比,痛风患者发生肺炎、UTI 或感染相关死亡的风险并未降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b99/5431148/f01596b1957e/41598_2017_1588_Fig1_HTML.jpg

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