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强直性脊柱炎患者死亡相关因素有经济、合并症和髋关节置换术

 

 

作者:Exarchou S, et al.

翻译:北京大学首钢医院 丁艳(ding820626@163.com)

审校: 王宽婷

摘要:目的: 目前关于强直性脊柱炎死亡率的研究很少。因此,本研究旨在评估:(1)强直性脊柱炎患者和普通人群的死亡率比较;(2)强直性脊柱炎患者死亡的影响因素。
方法: 来自全国疾病登记数据库的风湿科或内科门诊所诊断的强直性脊柱炎患者(n = 8600)为研究对象,来自于人口普查登记的一般人群为对照组(N = 40460),对照组与强直性脊柱炎患者的年龄、性别及地区相匹配。随访期限从2006年1月1日或疾病初次诊断开始,随访终点为死亡、移民或2012年12月31日。从疾病登记资料中的获取患者的社会经济因素、临床表现、关节手术、并发症和治疗药物。用Cox回归模型来确定强直性脊柱炎患者的死亡率和死亡影响因素。
结果: 强直性脊柱炎患者中有496例死亡,对症组中有1533例死亡。年龄和性别调整后的HR为1.60(95% CI 1.44至1.77),男性(年龄调整后的HR = 1.53,95% CI 1.36至1.72)和女性(年龄调整后的HR = 1.83,95% CI 1.50至2.22)患者的死亡率均增加。在强直性脊柱炎组,与死亡率相关的因素包括教育水平较低、常见的合并症(糖尿病、感染、心血管疾病、肺部疾病和恶性肿瘤)和髋关节置换手术。

结论:强直性脊柱炎患者中男性和女性患者的死亡率均增加。与死亡相关

的因素包括社会经济因素、常见的合并症和髋关节置换手术。

附原文:Objectives Information on mortality in ankylosing spondylitis (AS) is scarce. Our study therefore aimed to assess: (1) mortality in AS versus the general population, and (2) predictors of death in the AS population.Methods Nationwide cohorts of patients with AS diagnosed at rheumatology or internal medicine outpatient clinics (n=8600) and age-matched, sex-matched and county-matched general population comparators (n=40 460) were identified from the National Patient Register and the census register, respectively. The follow-up period began on 1 January 2006 or at the first date of registered diagnosis thereafter and extended until death, emigration or 31 December 2012, whichever occurred first. Socioeconomic variables, AS-related clinical manifestations, joint surgery, comorbidities and medication were identified from other national registers. Cox regression models were used to determine mortality and predictors for death in the AS cohort. Results There were 496 deaths in the AS cohort and 1533 deaths in the control cohort resulting in an age-adjusted and sex-adjusted HR of 1.60 (95% CI 1.44 to 1.77), with increased mortality for men (age-adjusted HR=1.53, 95% CI 1.36 to 1.72) and women (ageadjusted HR=1.83, 95% CI 1.50 to 2.22). Within the AS cohort, statistically significant predictors for death were a lower level of education, general comorbidities (diabetes, infections, cardiovascular, pulmonary and malignant diseases) and previous hip replacement surgery. Conclusions Mortality was increased for male and female patients with AS. Predictors of death within the AS cohort included socioeconomic status, general comorbidities and hip replacement surgery.
引自:Exarchou S, et al. Mortality in ankylosing spondylitis: results from a nationwide population-based study . Ann Rheum Dis 2016;75:1466–1472

上海强直医院

致力于为患者提供国际化高品质医疗服务


1、仪器设备保障。斥资从国外引进多台先进设备,如医用红外热成像仪、净化祛炎生物、高频水针治疗仪等,全程可视化操作,打破传统治疗对无菌性炎症的盲区……【详情】

 

2、技术保障。依据患者病情、身体状况、耐药性等从免疫学、康复学、内科学、脊柱微创学等多学科领域联合治疗,个性施治,诊疗方案集查炎、祛炎、修复骨质、调节免疫为一体……【详情】

 

3、医生保障。严格要求一线诊疗医生对强直诊疗经验必须超过15年,疑难重症患者不少于2位医生共同会诊制定方案……【详情】

 

4、疗效保障。凭借口碑及疗效吸引大批全国各地强直患者前来就诊,多数辗转全国各大医院不得治,其中不乏国外患者……【详情】

 

5、愈后保障。建立术后回访、疗效跟踪、APP健康秘书服务等愈后保障服务,使患者即使出院也能享受专业、贴心的医疗服务……【详情】

日期:  2016-10-10 15:45:46         发布者:  上海强直医院
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