Jennum Poul, Thorstensen Eva Wiberg, Pickering Line, Ibsen Rikke, Kjellberg Jakob
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Sleep Med. 2017 Aug;36:23-28. doi: 10.1016/j.sleep.2017.03.029. Epub 2017 May 19.
The objective of the study was to evaluate the morbidities and mortality in a national group of middle-aged and elderly narcolepsy patients before and after the first diagnosis of the condition.
From the Danish National Patient Registry (NPR), 1174 patients (45.1% males) aged 20-59 years and 339 patients (44.8% males) aged 60+ who received a diagnosis of narcolepsy between 1998 and 2014 were compared, respectively, with 4716 and 1353 control citizens matched for age, gender and geography, who were randomly chosen from the Danish Civil Registration System Statistics. In the NPR, all morbidities are grouped into major WHO classes.
Middle-aged and elderly patients had more health contacts before and after their narcolepsy diagnosis with respect to several disease domains: infections, neoplasm, endocrine/metabolic diseases/diabetes, mental/psychiatric, neurological (including epilepsy), eye, cardiovascular (hypertension, ischemic heart disease), respiratory (upper-airway infections, sleep apnea), gastrointestinal, musculoskeletal (including discopathies) and skin diseases. Narcolepsy patients had lower reproductive rates. Furthermore, patients showed significantly more health contacts due to the evaluation and control contacts for disease and symptoms. Patients suffered from significantly more multiple diseases than did controls. The 17-year hazard ratio mortality rates were 1.35 (95% CI, 0.94-1.95, p = 0.106) among 20-59 year-olds, and 1.38 (1.12-1.69, p = 0.002) among those aged 60+ years.
There are higher rates of morbidity in several disease domains before and after a diagnosis of narcolepsy. Elderly narcolepsy patients have higher mortality rates.
本研究的目的是评估全国中年及老年发作性睡病患者首次确诊该病前后的发病率和死亡率。
从丹麦国家患者登记处（NPR）选取了1998年至2014年间被诊断为发作性睡病的1174名年龄在20 - 59岁的患者（男性占45.1%）和339名年龄在60岁及以上的患者（男性占44.8%），分别与从丹麦民事登记系统统计数据中随机选取的4716名和1353名年龄、性别和地理位置相匹配的对照公民进行比较。在NPR中，所有疾病都按照世界卫生组织的主要类别进行分组。
中年及老年发作性睡病患者在确诊该病前后，在几个疾病领域的医疗接触更多：感染、肿瘤、内分泌/代谢疾病/糖尿病、精神/心理、神经（包括癫痫）、眼部、心血管（高血压、缺血性心脏病）、呼吸（上呼吸道感染、睡眠呼吸暂停）、胃肠道、肌肉骨骼（包括椎间盘疾病）和皮肤疾病。发作性睡病患者的生殖率较低。此外，由于对疾病和症状的评估及控制接触，患者的医疗接触明显更多。患者患多种疾病的情况明显多于对照组。20 - 59岁人群的17年死亡风险比为1.35（95%置信区间，0.94 - 1.95，p = 0.106），60岁及以上人群为1.38（1.12 - 1.69，p = 0.002）。
发作性睡病确诊前后，在几个疾病领域的发病率较高。老年发作性睡病患者的死亡率较高。
