Tsai Ching-Shu, Chen Vincent Chin-Hung, Yang Yao-Hsu, Hung Tai-Hsin, Lu Mong-Liang, Huang Kuo-You, Gossop Michael
Department of Psychiatry, Chang Gung Memorial Hospital and University, Chiayi, Taiwan.
Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.
PLoS One. 2017 Jul 3;12(7):e0180402. doi: 10.1371/journal.pone.0180402. eCollection 2017.
Manifestations of Mycoplasma pneumoniae infection can range from self-limiting upper respiratory symptoms to various neurological complications, including speech and language impairment. But an association between Mycoplasma pneumoniae infection and speech and language impairment has not been sufficiently explored. In this study, we aim to investigate the association between Mycoplasma pneumoniae infection and subsequent speech and language impairment in a nationwide population-based sample using Taiwan's National Health Insurance Research Database. We identified 5,406 children with Mycoplasma pneumoniae infection (International Classification of Disease, Revision 9, Clinical Modification code 4830) and compared to 21,624 age-, sex-, urban- and income-matched controls on subsequent speech and language impairment. The mean follow-up interval for all subjects was 6.44 years (standard deviation = 2.42 years); the mean latency period between the initial Mycoplasma pneumoniae infection and presence of speech and language impairment was 1.96 years (standard deviation = 1.64 years). The results showed that Mycoplasma pneumoniae infection was significantly associated with greater incidence of speech and language impairment [hazard ratio (HR) = 1.49, 95% CI: 1.23-1.80]. In addition, significantly increased hazard ratio of subsequent speech and language impairment in the groups younger than 6 years old and no significant difference in the groups over the age of 6 years were found (HR = 1.43, 95% CI:1.09-1.88 for age 0-3 years group; HR = 1.67, 95% CI: 1.25-2.23 for age 4-5 years group; HR = 1.14, 95% CI: 0.54-2.39 for age 6-7 years group; and HR = 0.83, 95% CI:0.23-2.92 for age 8-18 years group). In conclusion, Mycoplasma pneumoniae infection is temporally associated with incident speech and language impairment.
肺炎支原体感染的表现范围从自限性上呼吸道症状到各种神经系统并发症，包括言语和语言障碍。但肺炎支原体感染与言语和语言障碍之间的关联尚未得到充分探究。在本研究中，我们旨在利用台湾国民健康保险研究数据库，在全国范围内基于人群的样本中调查肺炎支原体感染与随后出现的言语和语言障碍之间的关联。我们确定了5406名肺炎支原体感染儿童（国际疾病分类，第9版，临床修订版代码483.0），并与21624名年龄、性别、城市和收入匹配的对照者比较随后出现的言语和语言障碍情况。所有受试者的平均随访间隔为6.44年（标准差=2.42年）；初次肺炎支原体感染与言语和语言障碍出现之间的平均潜伏期为1.96年（标准差=1.64年）。结果显示，肺炎支原体感染与言语和语言障碍的发生率显著相关[风险比（HR）=1.49，95%置信区间：1.23-1.80]。此外，发现6岁以下组随后出现言语和语言障碍的风险比显著增加，6岁以上组无显著差异（0-3岁年龄组HR=1.43，95%置信区间：1.09-1.88；4-5岁年龄组HR=1.67，95%置信区间：1.25-2.23；6-7岁年龄组HR=1.14，95%置信区间：0.54-2.39；8-18岁年龄组HR=0.83，95%置信区间：0.23-2.92）。总之，肺炎支原体感染与新发言语和语言障碍在时间上相关。
