Winther J F, Bach F W, Friis S, Blot W J, Mellemkjaer L, Kjøller K, Høgsted C, McLaughlin J K, Olsen J H
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen.
Neurology. 1998 Apr;50(4):951-5. doi: 10.1212/wnl.50.4.951.
To investigate the risk of neurologic disease among women with silicone breast implants.
Since 1992, several case series reported an association between silicone breast implants and neurologic diseases.
Between 1977 and 1992, 1,135 women received cosmetic silicone breast implants, and 7,071 women had breast reduction surgery, as identified by the Danish National Register of Patients (NRP). NRP files provided information on numbers and types of subsequent neurologic disorders at hospital discharge, which were compared with expected numbers, calculated on the basis of national hospital discharge rates.
In the two study cohorts, hospital discharge rates for neurologic diseases were raised by some 60% to 70% compared with Danish women in general. Among women with silicone breast implants, 13 subsequently developed a neurologic disorder compared with 7.7 expected; whereas in the comparison group, 63 observed versus 39.1 expected disorders were recorded. These results indicate that relative to the comparison cohort, women with implants had no excessive levels of definite neurologic disease. Furthermore, medical record reviews revealed that the majority of women with implants discharged with a neurologic diagnosis had either symptoms before implant surgery or neurologic symptoms secondary to degenerative diseases.
Our findings do not support the hypothesis of silicone-induced neurologic disease. The reasons for the elevated rates of neurologic disease in both the exposed and comparison cohorts remain unclear, but may reflect selection processes associated with these women seeking medical care more often than the general population.
研究接受硅胶乳房植入物的女性患神经系统疾病的风险。
自1992年以来，有几个病例系列报道了硅胶乳房植入物与神经系统疾病之间的关联。
通过丹麦国家患者登记处（NRP）确定，在1977年至1992年期间，1135名女性接受了美容性硅胶乳房植入，7071名女性接受了乳房缩小手术。NRP档案提供了出院时后续神经系统疾病的数量和类型信息，并与根据全国出院率计算出的预期数量进行比较。
在这两个研究队列中，与丹麦普通女性相比，神经系统疾病的出院率提高了约60%至70%。在接受硅胶乳房植入的女性中，有13人随后患上了神经系统疾病，而预期为7.7人；而在对照组中，观察到63例疾病，预期为39.1例。这些结果表明，与对照组相比，植入假体的女性确诊神经系统疾病的水平并未过高。此外，病历审查显示，大多数因神经系统诊断而出院的植入假体女性，要么在植入手术前就有症状，要么是由退行性疾病继发的神经系统症状。
我们的研究结果不支持硅胶诱发神经系统疾病的假说。暴露组和对照组中神经系统疾病发病率升高的原因尚不清楚，但可能反映了与这些女性比普通人群更频繁寻求医疗护理相关的选择过程。
