干燥综合征患者非结核分枝杆菌感染的风险：一项基于全国人群的队列研究。
The risk of nontuberculous mycobacterial infection in patients with Sjögren's syndrome: a nationwide, population-based cohort study.
作者信息
Chao Wen-Cheng, Lin Ching-Heng, Liao Tsai-Ling, Chen Yi-Ming, Hsu Chiann-Yi, Chen Jun-Peng, Chen Der-Yuan, Chen Hsin-Hua
机构信息
Department of Medical Research, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sect. 4, Taichung, 40705, Taiwan.
Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
出版信息
BMC Infect Dis. 2017 Dec 28;17(1):796. doi: 10.1186/s12879-017-2930-7.
BACKGROUND
Nontuberculous mycobacterial (NTM) infection in immunocompromized patients is currently a growing health concern, and we aimed to examine the relative risk of NTM infection in patients with Sjögren's syndrome (SS) compared with that in non-SS individuals.
METHODS
We used the 2003-2012 Taiwanese National Health Insurance Research Database to identify 6554 incident SS cases during 2007-2012 and selected 98,310 non-SS controls matched (1:15) for age, gender, and the year of first SS diagnosis date after excluding those who had rheumatoid arthritis or systemic lupus erythematosus.
RESULTS
We identified four NTM-infected patients in the SS group (three in the first year) and nine in the non-SS group (three in the first year). SS patients had a higher incidence rate of NTM infection than that in non-SS individuals (IRR, 7.56; 95% CI, 2.33-24.55), especially during the first year (IRR, 16.05; 95% CI, 3.24-79.51). After adjusting for potential confounders, the risk of NTM infection was not increased in SS patients during the entire follow-up period or during the first year, but the risk increased in SS patients treated with immunosuppressants during the entire follow-up period (HR, 17.77; 95% CI, 4.53-69.61), especially during the first year (HR, 33.33; 95% CI, 4.37-254.23).
CONCLUSION
An increased risk of NTM infection was found in SS patients treated with immunosuppressants during the first year after SS diagnosis.
背景
免疫功能低下患者的非结核分枝杆菌（NTM）感染目前是一个日益严重的健康问题，我们旨在研究干燥综合征（SS）患者与非SS个体相比NTM感染的相对风险。
方法
我们使用2003 - 2012年台湾国民健康保险研究数据库，在2007 - 2012年期间识别出6554例新发病的SS病例，并选择了98310名年龄、性别和首次SS诊断日期相匹配（1:15）的非SS对照，排除了患有类风湿性关节炎或系统性红斑狼疮的患者。
结果
我们在SS组中发现4例NTM感染患者（第一年3例），在非SS组中发现9例（第一年3例）。SS患者的NTM感染发病率高于非SS个体（发病率比，7.56；95%置信区间，2.33 - 24.55），尤其是在第一年（发病率比，16.05；95%置信区间，3.24 - 79.51）。在调整潜在混杂因素后，SS患者在整个随访期或第一年期间NTM感染风险并未增加，但在整个随访期接受免疫抑制剂治疗的SS患者中风险增加（风险比，17.77；95%置信区间，4.53 - 69.61），尤其是在第一年（风险比，33.33；95%置信区间，4.37 - 254.23）。
结论
在SS诊断后的第一年，接受免疫抑制剂治疗的SS患者中发现NTM感染风险增加。
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