肌萎缩侧索硬化症患者干预率的种族差异：一项病例对照研究。
Racial differences in intervention rates in individuals with ALS: A case-control study.
机构信息
From the Department of Neurosciences, Health Disparities in Neuroscience-related Disorders Program (S.Q., C.M.), and Departments of Biostatistics and Data Science (C.D.L.) and Neurology (J.B.C., M.S.C.), Wake Forest School of Medicine, Winston-Salem, NC.
出版信息
Neurology. 2019 Apr 23;92(17):e1969-e1974. doi: 10.1212/WNL.0000000000007366. Epub 2019 Mar 27.
OBJECTIVE
This study was conducted to determine whether longer lifespans in African Americans with amyotrophic lateral sclerosis (ALS), compared to white non-Hispanics, are secondary to higher rates of tracheostomy and invasive ventilation (TIV) in African Americans.
METHODS
A retrospective case-control study was conducted with 49 African Americans with ALS matched by age, gender, and site of onset to 137 white persons with ALS.
RESULTS
African Americans had longer survival than whites when the outcome was death ( = 0.016), but this was no longer significant when the outcome was death or TIV ( = 0.100). African Americans also had a lower rate of noninvasive ventilation use compared to whites (27 [55%] vs 96 [70%], = 0.015) and a higher rate of TIV (8 [16%] vs 7 [5%], = 0.016), but after controlling for baseline severity, only the noninvasive ventilation difference ( = 0.036), and not the TIV difference ( = 0.115), remained significant.
CONCLUSION
African Americans with ALS live longer than white persons with ALS, and this may be secondary to higher rates of TIV use among African Americans.
目的
本研究旨在确定与白人非西班牙裔相比，非裔美国人肌萎缩侧索硬化症（ALS）患者的寿命更长是否是由于非裔美国人气管切开术和侵入性通气（TIV）的比例较高所致。
方法
对 49 名非裔美国 ALS 患者进行回顾性病例对照研究，这些患者按年龄、性别和发病部位与 137 名白人 ALS 患者相匹配。
结果
以死亡为结局时，非裔美国人的生存时间长于白人（=0.016），但当结局为死亡或 TIV 时，这一差异不再显著（=0.100）。与白人相比，非裔美国人使用无创通气的比例较低（27[55%] vs 96[70%]，=0.015），而 TIV 的比例较高（8[16%] vs 7[5%]，=0.016），但在控制基线严重程度后，只有无创通气的差异（=0.036），而 TIV 的差异（=0.115）不再显著。
结论
非裔美国人肌萎缩侧索硬化症患者的寿命长于白人患者，这可能是由于非裔美国人 TIV 使用比例较高所致。
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