Wang Shuya, Wei James Cheng-Chung, Huang Jing-Yang, Perng Wuu-Tsun, Zhang Zhiyi
Department of Rheumatology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Rheumatology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Int J Rheum Dis. 2020 Feb;23(2):181-188. doi: 10.1111/1756-185X.13650. Epub 2019 Jul 23.
The incident rate of herpes zoster (HZ) is higher in some autoimmune diseases; however the relationship of HZ and ankylosing spondylitis (AS) is still unclear. This research aims to determine the incidence of HZ in Taiwan AS patients.
This study included 2819 AS patients and 11 276 non-AS controls between 2003 and 2013. All participants were selected from the Longitudinal Health Insurance Database 2000 Taiwan. The endpoint was diagnosis of HZ by International Classification of Diseases, Ninth Revision, Clinical Modification coding for at least 3 outpatient visits or one admission until the end of 2013. We used Chi-square test, Cox proportional hazard models and a Kaplan-Meier analysis to calculate the hazards ratio (HR), disease-free survival and incidental density of HZ. Subgroup analysis and sensitivity tests were also done.
Comorbidities such as chronic urticaria, inflammatory bowel disease, thyroid disorders, hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, cerebrovascular accident, were higher in patients with AS than that in controls. Patients age ≥60 or comorbid disease such as thyroid disorders or cancer had a higher HR of HZ; the adjusted HRs were 2.273 (95% CI 1.314-3.931), 1.577 (95% CI 1.008-2.466) and 1.855 (95% CI 1.248-2.758) respectively, on multivariable modeling. The crude HR for HZ among AS patient was 1.178 (95% CI 0.953-1.455, P > 0.05), and the adjust HZ was 1.070 (95% CI 0.835-1.371, P > 0.05), compared to non-AS controls.
There is no difference in incidence rate of HZ between Taiwan AS patients and non-AS controls. Among AS patients, age and cancer were major risk factors for incidental HZ.
某些自身免疫性疾病中带状疱疹（HZ）的发病率较高；然而，HZ与强直性脊柱炎（AS）之间的关系仍不明确。本研究旨在确定台湾AS患者中HZ的发病率。
本研究纳入了2003年至2013年间的2819例AS患者和11276例非AS对照。所有参与者均选自台湾2000年纵向健康保险数据库。终点是根据国际疾病分类第九版临床修订本编码诊断为HZ，至少有3次门诊就诊或1次住院，直至2013年底。我们使用卡方检验、Cox比例风险模型和Kaplan-Meier分析来计算风险比（HR）、无病生存期和HZ的发病密度。还进行了亚组分析和敏感性测试。
AS患者的慢性荨麻疹、炎症性肠病、甲状腺疾病、高血压、糖尿病、高脂血症、冠状动脉疾病、脑血管意外等合并症高于对照组。年龄≥60岁或患有甲状腺疾病或癌症等合并症的患者HZ的HR较高；在多变量模型中，调整后的HR分别为2.273（95%CI 1.314-3.931）、1.577（95%CI 1.008-2.466）和1.855（95%CI 1.248-2.758）。与非AS对照相比，AS患者中HZ的粗HR为1.178（95%CI 0.953-1.455，P>0.05），调整后的HZ为1.070（95%CI 0.835-1.371，P>0.05）。
台湾AS患者与非AS对照之间HZ的发病率没有差异。在AS患者中，年龄和癌症是偶发性HZ的主要危险因素。
