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葡萄膜炎对角膜病变发展的影响:基于人群的队列研究。

Effect of Uveitis on the Development of Keratopathy: A Population-Based Cohort Study.

机构信息

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan.

出版信息

Invest Ophthalmol Vis Sci. 2018 Oct 1;59(12):5053-5059. doi: 10.1167/iovs.18-25039.

Abstract

PURPOSE

The purpose of this study was to evaluate the effect of uveitis on the development of various keratopathies via the use of the National Health Insurance Research Database (NHIRD) in Taiwan.

METHODS

Approximately 1 million patients were randomly sampled from the registry of the NHIRD. Patients diagnosed with uveitis by ophthalmologists were enrolled in the study group after exclusion. Each individual in the study group was age and sex matched to four non-uveitis individuals who serve as the control group. In addition to keratopathy, other possible risk factors and medications were included in the multivariate model, and the effects of different subtypes of uveitis for developing keratopathies were also analyzed.

RESULTS

A total of 4773 uveitis patients (2662 male and 2111 female) and 19,092 non-uveitis patients (10,648 male and 8444 female) were enrolled. There were 406 events of keratopathy in the study group, and another 764 events occurred in the control group. A higher incidence rate was found in the study group after adjustment (adjusted hazard ratio [aHR]: 1.772), with a greater cumulative probability (P < 0.0001). For the subgroup analysis, anterior uveitis (aHR = 1.765) and panuveitis (aHR = 3.386) increased the risk of developing keratopathies. Moreover, male sex was associated with a higher aHR than female sex for developing keratopathies in the study group.

CONCLUSIONS

The presence of uveitis significantly elevates the risk for developing keratopathy.

摘要

目的

本研究旨在利用台湾全民健康保险研究数据库(NHIRD)评估葡萄膜炎对各种角膜病变发展的影响。

方法

从 NHIRD 登记处随机抽取约 100 万名患者。排除眼科医生诊断为葡萄膜炎的患者后,将其纳入研究组。研究组中的每位患者与 4 名非葡萄膜炎个体按年龄和性别匹配作为对照组。除了角膜病变外,还将其他可能的危险因素和药物纳入多变量模型,并分析不同类型的葡萄膜炎对角膜病变发展的影响。

结果

共纳入 4773 例葡萄膜炎患者(男 2662 例,女 2111 例)和 19092 例非葡萄膜炎患者(男 10648 例,女 8444 例)。研究组中有 406 例角膜病变事件,对照组中有 764 例。调整后研究组的发生率更高(调整后的危险比[aHR]:1.772),累积概率更大(P<0.0001)。亚组分析显示,前葡萄膜炎(aHR=1.765)和全葡萄膜炎(aHR=3.386)增加了角膜病变的发病风险。此外,与女性相比,男性在研究组中发生角膜病变的 aHR 更高。

结论

葡萄膜炎的存在显著增加了角膜病变的发病风险。

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