芬兰儿科创伤性脑损伤与早发性多发性硬化症：一项基于全国登记的队列研究。
Pediatric traumatic brain injury and early age multiple sclerosis in Finland: A nationwide register-based cohort study.
机构信息
School of Medicine, University of Tampere, Tampere, Finland.
Department of Surgery, Hospital Nova of Central Finland, Jyväskylä, Finland.
出版信息
Brain Behav. 2024 Apr;14(4):e3478. doi: 10.1002/brb3.3478.
OBJECTIVE
Examine the link between pediatric traumatic brain injury (pTBI) and early-onset multiple sclerosis in Finland.
METHODS
Conducted nationwide register study (1998-2018) with 28,750 pTBI patients (< 18) and 38,399 pediatric references with extremity fractures. Multiple sclerosis diagnoses from Finnish Social Insurance Institution. Employed Kaplan-Meier and multivariable Cox regression for probability assessment, results presented with 95% CI.
RESULTS
Of 66 post-traumatic multiple sclerosis cases, 30 (0.10%) had pTBI, and 36 (0.09%) were in the reference group. Cumulative incidence rates (CIR) in the first 10 years were 46.5 per 100,000 (pTBI) and 33.1 per 100,000 (reference). Hazard ratio (HR) for pTBI was 1.10 (95% CI: 0.56-1.48).Stratified by gender, women's CIR was 197.9 per 100,000 (pTBI) and 167.0 per 100,000 (reference) after 15 years. For men, CIR was 44.6 per 100,000 (pTBI) and 34.7 per 100,000 (reference). In the initial 3 years, HR for female pTBI was 1.75 (95% CI: 0.05-6.32), and between years 3 and 20, it was 1.08 (95% CI: 0.51-1.67). For male patients, HR was 1.74 (95% CI: 0.69-4.39).
SIGNIFICANCE
We did not find evidence of an association between pTBI and early-onset multiple sclerosis 20 years post-initial trauma.
目的
研究芬兰小儿外伤性脑损伤（pTBI）与早发性多发性硬化症之间的关联。
方法
进行了一项全国性的注册研究（1998-2018 年），纳入了 28750 名 pTBI 患者（<18 岁）和 38399 名患有四肢骨折的儿科参考患者。多发性硬化症的诊断来自芬兰社会保险机构。采用 Kaplan-Meier 和多变量 Cox 回归进行概率评估，结果以 95%CI 呈现。
结果
在 66 例创伤后多发性硬化症病例中，30 例（0.10%）有 pTBI，36 例（0.09%）在参考组中。在最初的 10 年内，累积发病率（CIR）在 pTBI 组为 46.5/10 万，在参考组为 33.1/10 万。pTBI 的风险比（HR）为 1.10（95%CI：0.56-1.48）。按性别分层，女性在 pTBI 组的 CIR 为 197.9/10 万，而在参考组为 167.0/10 万，随访 15 年。对于男性，CIR 在 pTBI 组为 44.6/10 万，在参考组为 34.7/10 万。在最初的 3 年内，女性 pTBI 的 HR 为 1.75（95%CI：0.05-6.32），而在 3 至 20 年内，HR 为 1.08（95%CI：0.51-1.67）。对于男性患者，HR 为 1.74（95%CI：0.69-4.39）。
意义
我们没有发现 pTBI 与初始创伤后 20 年早发性多发性硬化症之间存在关联的证据。
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