台湾成年系统性红斑狼疮女性患者行关节置换手术的风险：一项基于人群的队列研究。
Risk of joint replacement surgery in Taiwanese female adults with systemic lupus erythematosus: a population-based cohort study.
机构信息
Division of Obstetrics and Gynecology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
出版信息
BMC Musculoskelet Disord. 2019 Jul 6;20(1):314. doi: 10.1186/s12891-019-2698-6.
BACKGROUND
Female patients with systemic lupus erythematosus (SLE) are prone to have musculoskeletal system involvement, which could lead to joint damage. However, few studies have assessed the incidence of arthroplasty in female patients with SLE. The aim of this study was to investigate the risk of total hip replacement surgery and total knee replacement surgery in patients with SLE.
METHODS
We identified 577 female patients with newly diagnosed SLE between 2000 and 2012 using the Taiwan's National Health Insurance Research Database. A comparison cohort was constructed with female patients without SLE in a ratio of 5:1, based on frequency matching for 10-year age interval, and index year, for each patient with SLE. Both cohorts were followed until a diagnosis of the study outcomes or the end of the follow-up period.
RESULTS
Female patients with SLE showed a significantly higher incidence of receiving total hip replacement surgery (adjusted incidence rate ratio [aIRR] 6.47; P < 0.001), but not total knee replacement surgery (aIRR 1.81; P = 0.227). Moreover, age-group stratified analyses indicated a high incidence for receiving total hip replacement surgery among young female patients with SLE (aIRR 7.70; P = 0.001).
CONCLUSION
Young female patients with SLE had a high risk of receiving total hip replacement surgery, but not total knee replacement surgery.
背景
患有系统性红斑狼疮（SLE）的女性患者容易出现肌肉骨骼系统受累，从而导致关节损伤。然而，很少有研究评估 SLE 女性患者关节置换术的发生率。本研究旨在探讨 SLE 患者接受全髋关节置换术和全膝关节置换术的风险。
方法
我们使用台湾全民健康保险研究数据库，于 2000 年至 2012 年间确定了 577 名新诊断为 SLE 的女性患者。根据 SLE 患者的年龄间隔为 10 年，指数年进行频率匹配，为每位 SLE 患者构建了一个与无 SLE 的女性患者比例为 5:1 的对照组。两组患者均随访至研究结果诊断或随访期结束。
结果
SLE 女性患者接受全髋关节置换术的发生率明显较高（调整后的发病率比 [aIRR] 6.47；P<0.001），但接受全膝关节置换术的发生率并无差异（aIRR 1.81；P=0.227）。此外，年龄组分层分析表明，年轻 SLE 女性患者接受全髋关节置换术的发生率较高（aIRR 7.70；P=0.001）。
结论
年轻的 SLE 女性患者接受全髋关节置换术的风险较高，但接受全膝关节置换术的风险并不高。
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