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堪萨斯分枝杆菌肺病发病的危险因素:韩国的一项病例对照研究。

Risk factors for developing Mycobacterium kansasii lung disease: A case-control study in Korea.

作者信息

Kim Jin Hyoung, Seo Kwang Won, Shin Yongjoon, Oh Ji Seon, Jun Jae-Bum, Jeong Joseph, Sim Chang Sun, Baek Seunghee, Lee Taehoon, Ahn Jong Joon

机构信息

Department of Internal Medicine.

Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan.

出版信息

Medicine (Baltimore). 2019 Feb;98(5):e14281. doi: 10.1097/MD.0000000000014281.

Abstract

Previous studies have suggested that development of Mycobacterium kansasii lung disease (MKLD) was associated with COPD, pneumoconiosis, aging, male, immunosuppression, alcohol, malignancy, and certain occupations such as mining and sandblasting. However, previous studies were outdated and used non-comparative statistical methods. We aimed to determine the current risk factors for developing MKLD in Korea by using appropriate statistical techniques.Eighty-six MKLD patients were identified through a search of the Ulsan University Hospital database between January 2010 and December 2014. These cases were matched with 172 controls who had normal respiratory systems in a health examination during the same period (matching variables, age and sex; case: control ratio of 1:2). Clinical and demographic characteristics were gathered by reviewing the medical record and telephone survey. Multivariate logistic regression analyses were performed to evaluate risk factors for developing MKLD.Multivariate analysis showed that occupation in heavy industries (adjusted odds ratio (aOR) 6.41, 95% confidence interval (CI) 2.19-18.74, P = .001) and low body mass index (BMI) (aOR [per kg/m] 0.73, 95% CI 0.63-0.85, P < .001) were independent risk factors for development of MKLD. Educational attainment more than high school was associated with a lower risk of MKLD development (aOR 0.22, 95% CI 0.08-0.63, P = .005).Employees in heavy industry and low BMI are independent risk factors for development of MKLD in Korea.

摘要

既往研究提示,堪萨斯分枝杆菌肺病(MKLD)的发生与慢性阻塞性肺疾病(COPD)、尘肺、衰老、男性、免疫抑制、饮酒、恶性肿瘤以及某些职业(如采矿和喷砂)有关。然而,既往研究已过时且采用的是非比较性统计方法。我们旨在运用适当的统计技术确定韩国目前发生MKLD的危险因素。

通过检索蔚山大学医院2010年1月至2014年12月的数据库,确定了86例MKLD患者。这些病例与同期健康体检中呼吸系统正常的172例对照进行匹配(匹配变量为年龄和性别;病例与对照比例为1:2)。通过查阅病历和电话调查收集临床和人口统计学特征。进行多因素逻辑回归分析以评估发生MKLD的危险因素。

多因素分析显示,重工业职业(校正比值比[aOR] 6.41,95%置信区间[CI] 2.19 - 18.74,P = 0.001)和低体重指数(BMI)(aOR[每kg/m²] 0.73,95% CI 0.63 - 0.85,P < 0.001)是发生MKLD的独立危险因素。高中以上学历与MKLD发生风险较低相关(aOR 0.22,95% CI 0.08 - 0.63,P = 0.005)。

在韩国,重工业从业者和低BMI是发生MKLD的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb96/6380715/fc6e6400b7ad/medi-98-e14281-g005.jpg

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