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乳房植入物与非特异性症状、结缔组织疾病及过敏反应的关联:一项回顾性队列分析

Association of Breast Implants with Nonspecific Symptoms, Connective Tissue Diseases, and Allergic Reactions: A Retrospective Cohort Analysis.

作者信息

Barbosa Monica R, Makris Una E, Mansi Ishak A

机构信息

From the Medical Service, VA North Texas Health System; and the Departments of Internal Medicine and Population and Data Sciences, University of Texas Southwestern Medical Center.

出版信息

Plast Reconstr Surg. 2021 Jan 1;147(1):42e-49e. doi: 10.1097/PRS.0000000000007428.

Abstract

BACKGROUND

Given the rising media attention regarding various adverse conditions attributed to breast implants, the authors examined the association between breast implantation and the risk of being diagnosed with connective tissue diseases, allergic reactions, and nonspecific constitutional complaints in a cohort study with longitudinal follow-up.

METHODS

Women enrolled in a regional military health care system between 2003 and 2012 were evaluated in this retrospective cohort study. A propensity score was generated to match women who underwent breast implantation with women who did not undergo breast implantation. The propensity score included age, social history, health care use, comorbidities, and medication use. Outcomes assessed included International Classification of Diseases, Ninth Revision, diagnoses codes for (1) nonspecific constitutional symptoms, (2) nonspecific cardiac conditions, (3) rheumatoid arthritis and systemic lupus erythematosus, (4) other connective tissue diseases, and (5) allergic reactions.

RESULTS

Of 22,063 women included in the study (513 breast implants and 21,550 controls), we propensity score-matched 452 breast implant recipients with 452 nonrecipients. Odds ratios and 95 percent confidence intervals in breast implant recipients compared to nonrecipients were similar, including nonspecific constitutional symptoms (OR, 0.77; 95 percent CI, 0.53 to 1.13), nonspecific cardiac conditions (OR, 0.97; 95 percent CI, 0.69 to 1.37), rheumatoid arthritis and systemic lupus erythematosus (OR, 0.66; 95 percent CI, 0.33 to 1.31), other connective tissue diseases (OR, 1.02; 95 percent CI, 0.78 to 1.32), and allergic reactions (OR, 1.18; 95 percent CI, 0.84 to 1.66).

CONCLUSIONS

Women with breast implants did not have an increased likelihood of being diagnosed with nonspecific constitutional symptoms, connective tissue disorders, and/or allergic reaction conditions.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

摘要

背景

鉴于媒体对乳房植入物引发的各种不良状况的关注度不断提高,作者在一项具有纵向随访的队列研究中,考察了乳房植入与被诊断出患有结缔组织疾病、过敏反应及非特异性全身性不适的风险之间的关联。

方法

在这项回顾性队列研究中,对2003年至2012年间纳入某地区军事医疗保健系统的女性进行了评估。生成倾向评分,以将接受乳房植入的女性与未接受乳房植入的女性进行匹配。倾向评分包括年龄、社会史、医疗保健利用情况、合并症及药物使用情况。评估的结局包括国际疾病分类第九版中关于以下方面的诊断编码:(1)非特异性全身性症状;(2)非特异性心脏疾病;(3)类风湿性关节炎和系统性红斑狼疮;(4)其他结缔组织疾病;(5)过敏反应。

结果

在纳入研究的22,063名女性(513名接受乳房植入者和21,550名对照者)中,我们通过倾向评分将452名乳房植入接受者与452名未接受者进行了匹配。与未接受者相比,乳房植入接受者的比值比及95%置信区间相似,包括非特异性全身性症状(比值比,0.77;95%置信区间,0.53至1.13)、非特异性心脏疾病(比值比,0.97;95%置信区间,0.69至1.37)、类风湿性关节炎和系统性红斑狼疮(比值比,0.66;95%置信区间,0.33至1.31)、其他结缔组织疾病(比值比,1.02;95%置信区间,0.78至1.32)以及过敏反应(比值比,1.18;95%置信区间,0.84至1.66)。

结论

接受乳房植入的女性被诊断出患有非特异性全身性症状、结缔组织疾病和/或过敏反应疾病的可能性并未增加。

临床问题/证据级别:治疗性,III级。

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