Salvarani C, Gabriel S E, O'Fallon W M, Hunder G G
Mayo Clinic, Rochester, Minnesota, USA.
Ann Intern Med. 1995 Aug 1;123(3):192-4. doi: 10.7326/0003-4819-123-3-199508010-00006.
To investigate trends in the incidence of giant cell arteritis over a 42-year period in Olmsted County, Minnesota.
Population-based incidence study.
Olmsted County, Minnesota.
All incidence cases of giant cell arteritis first diagnosed between 1950 and 1991 were identified using the unified record system at Mayo Clinic. Age- and sex-specific incidence rates were calculated using the number of incidence cases as the numerator and population estimates as the denominator. Overall rates were age- and sex-adjusted to the 1980 United States white population. The annual incidence rates were graphically illustrated using a 3-year centered moving average.
Between 1950 and 1991, 125 Olmsted County residents (103 women and 22 men) were diagnosed with giant cell arteritis. The age- and sex-adjusted incidence per 100,000 persons 50 years of age or older was 17.8 (95% CI, 14.7 to 21.0); incidence was significantly higher in women (24.2 [CI, 19.5 to 28.9]) than in men (8.2 [CI, 4.8 to 11.6]). Age-specific incidence rates increased with age (P < 0.0001). The annual incidence rates increased significantly over the study period (P = 0.002) and appear to have clustered in five peak periods, which occurred about every 7 years. A significant calendar-time effect was identified; it predicted an increase in incidence of 2.6% (CI, 0.9% to 4.3%) every 5 years.
Our observation of a regular cyclic pattern in incidence rates over time supports the hypothesis of an infectious cause for giant cell arteritis. Similar studies in other populations are needed to confirm our findings.
调查明尼苏达州奥尔姆斯特德县42年间巨细胞动脉炎的发病率趋势。
基于人群的发病率研究。
明尼苏达州奥尔姆斯特德县。
利用梅奥诊所的统一记录系统，确定1950年至1991年间首次诊断的所有巨细胞动脉炎发病病例。以发病病例数为分子、人口估计数为分母计算年龄和性别特异性发病率。总体发病率按年龄和性别调整至1980年美国白人人口。使用3年中心移动平均值以图形方式展示年发病率。
1950年至1991年间，125名奥尔姆斯特德县居民（103名女性和22名男性）被诊断为巨细胞动脉炎。年龄和性别调整后的50岁及以上人群每10万人发病率为17.8（95%可信区间，14.7至21.0）；女性发病率（24.2[可信区间，19.5至28.9]）显著高于男性（8.2[可信区间，4.8至11.6]）。年龄特异性发病率随年龄增加（P<0.0001）。在研究期间年发病率显著增加（P = 0.002），且似乎集中在五个高峰期，大约每7年出现一次。确定了显著的日历时间效应；预计每5年发病率增加2.6%（可信区间，0.9%至4.3%）。
我们观察到发病率随时间呈规律的周期性模式，这支持了巨细胞动脉炎由感染引起的假说。需要在其他人群中进行类似研究以证实我们的发现。
