探討幼年皮肌炎的發生率與共病風險- 台灣人口調查研究

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周光宇(Kuang-Yu Chou) 查詢紙本館藏

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系統生物與生物資訊研究所

論文名稱

探討幼年皮肌炎的發生率與共病風險- 台灣人口調查研究
(Incidence and Comorbidity Risk of Juvenile Dermatomyositis in Taiwan: A Nationwide Population Study)

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摘要(中)

背景：幼年型皮肌炎仍然作為一個罕見的但最常見的兒童的發炎性肌肉疾病。目前沒有大規模的研究已經做了有關的幼年型皮肌炎的長期共病。
目的與方法：本研究使用全民健康保險研究資料庫來計算不同的2001年至2010的幼年性皮肌炎發病率和相關共病的危險比。
結果：2001年至2010共168新診斷幼年性皮肌炎患者。總體而言，幼年性皮肌炎的平均發病率是3.12每百萬兒童，提供了一個男性對女性的比例為1:1.85 。幾乎所有年齡組中，女性發病率比男性高。長期共病的風險比顯著增加有感染疾病（ HR ： 3.118 ， 95 ％ CI ： 2.003 〜 4.854 ，P = <0.0001 ），肺結核病（ HR ： 10.057 ， 95 ％ CI ： 2.515 〜 40.215 ，P = 0.0011 ）心血管疾病（ HR ： 4.986 ，95％CI ： 2.643 〜 9.407 ，P = <0.0001 ）和眼部疾病（ HR ： 9.655 ，95％CI ： 3.801 〜 24.529 ，P = 0.0001 ）。在感染疾病中，顯著增加危險比為細菌性鼻竇炎，尿路感染，腹腔膿腫/腹膜炎。 168病人中並沒有得惡性腫瘤共病，在此族群研究中。
結論：
台灣幼年性皮肌炎發病率與之前與英國，美國和日本的報告結果相似。長期共病有顯著感染，肺結核，心血管疾病和眼部疾病。惡性腫瘤並非長期共病。未來實施標準化疾病監測後，以幫助醫生確定被低估幼年皮肌炎的共病上實際的疾病風險，可能是重要的

摘要(英)

Background:Juvenile dermatomyositis (JDM) remained as a rare but most common auto inflammatory myopathy in children. No large scale study had been done regarding long term comorbidities of the disease.
Objective and Methods:This study used the National Health Insurance Research Database was used to calculate the incidence and hazard ratio of different comorbidities of JDM patients from 2001 to 2010.
Results:A total of 168 newly diagnosis JDM patients were included in this cohort study from 2001 to 2010. Overall, the mean incidence of JDM was 3.12 per million children with a male to female ratio of 1:1.85. Female had a high incidence rate than male in nearly all age groups. Significant increase in hazard ratio (HR) were noted in infection (HR: 3.118, 95% CI: 2.003~4.854, P = <.0001), tuberculosis (HR: 10.057, 95% CI: 2.515~40.215, P = 0.0011), cardiovascular (HR: 4.986, 95% CI: 2.643~9.407, P = <.0001) and ocular diseases (HR: 9.655, 95% CI: 3.801~24.529, P = <.0001). Within infection group, significant increase in hazard ratio were bacterial sinusitis, urinary tract infection and abdominal abscess/peritonitis. None of the 168 JDM patient developed malignancy during this cohort study.
Conclusion:Taiwan JDM incidence rate is in general comparable with previous reports from UK, US and Japan with a female predominance. Long term comorbidities consisted of infection, tuberculosis, cardiovascular and ocular diseases. Malignancy is not one of the comorbidities. Implementing standardized monitoring protocol may be vital to help determine the actual disease risk in some of the underestimated JDM comorbidities in future studies.

關鍵字(中)

★ 幼年型皮肌炎
★ 發生率
★ 共病風險

關鍵字(英)

★ Juvenile Dermatomyositis
★ Incidence
★ Comorbidity Risk

論文目次

摘要 i
English Abstract ii
Table of Contents iii
List of Tables iv
List of Figures v
Chapter 1 Introduction 1
1-1 Background 1
1-2 Motivation 1
1-3 Research Goal 1
1-4 Related Works 2
Chapter 2 Materials and Methods 3
2-1 Data Source 3
2-2 NHIRD Field Selection 3
2-3 Study Population 4
2-4 Outcome 6
2-5 Statistical Analyses 6
2-5-1 Chi-square Test 7
2-5-2 Hazard Ratio 7
2-5-3 Kaplan–Meier Method 8
Chapter 3 Results 9
3-1 Baseline Characteristics 9
3-2 Incidence of JDM in Taiwan. 9
3-3 Comorbidities of JDM 12
Chapter 4 Discussions and Conclusions 20
References 24
Appendix 27

參考文獻

REFERENCES
1. Medsger TA, Jr., Dawson WN, Jr., Masi AT. The epidemiology of polymyositis. Am J Med 1970; 48:715-23.
2. Mendez EP, Lipton R, Ramsey-Goldman R, Roettcher P, Bowyer S, Dyer A, et al. US incidence of juvenile dermatomyositis, 1995-1998: results from the National Institute of Arthritis and Musculoskeletal and Skin Diseases Registry. Arthritis Rheum 2003; 49:300-5.
3. Oddis CV, Conte CG, Steen VD, Medsger TA, Jr. Incidence of polymyositis-dermatomyositis: a 20-year study of hospital diagnosed cases in Allegheny County, PA 1963-1982. J Rheumatol 1990; 17:1329-34.
4. Symmons DP, Sills JA, Davis SM. The incidence of juvenile dermatomyositis: results from a nation-wide study. Br J Rheumatol 1995; 34:732-6.
5. Pachman LM, Hayford JR, Chung A, Daugherty CA, Pallansch MA, Fink CW, et al. Juvenile dermatomyositis at diagnosis: clinical characteristics of 79 children. J Rheumatol 1998; 25:1198-204.
6. Miller LC, Michael AF, Kim Y. Childhood dermatomyositis. Clinical course and long-term follow-up. Clin Pediatr (Phila) 1987; 26:561-6.
7. Ramanan AV, Feldman BM. Clinical features and outcomes of juvenile dermatomyositis and other childhood onset myositis syndromes. Rheum Dis Clin North Am 2002; 28:833-57.
8. Sallum AM, Kiss MH, Sachetti S, Resende MB, Moutinho KC, Carvalho Mde S, et al. Juvenile dermatomyositis: clinical, laboratorial, histological, therapeutical and evolutive parameters of 35 patients. Arq Neuropsiquiatr 2002; 60:889-99.
9. Hanissian AS, Masi AT, Pitner SE, Cape CC, Medsger TA, Jr. Polymyositis and dermatomyositis in children: an epidemiologic and clinical comparative analysis. J Rheumatol 1982; 9:390-4.
10. Sullivan DB, Cassidy JT, Petty RE. Dermatomyositis in the pediatric patient. Arthritis Rheum 1977; 20:327-31.
11. Robinson AB, Reed AM. Clinical features, pathogenesis and treatment of juvenile and adult dermatomyositis. Nat Rev Rheumatol 2011; 7:664-75.
12. Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med 1975; 292:344-7.
13. Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med 1975; 292:403-7.
14. Ravelli A, Trail L, Ferrari C, Ruperto N, Pistorio A, Pilkington C, et al. Long-term outcome and prognostic factors of juvenile dermatomyositis: a multinational, multicenter study of 490 patients. Arthritis Care Res (Hoboken) 2010; 62:63-72.
15. Huber AM, Lang B, LeBlanc CM, Birdi N, Bolaria RK, Malleson P, et al. Medium- and long-term functional outcomes in a multicenter cohort of children with juvenile dermatomyositis. Arthritis Rheum 2000; 43:541-9.
16. Constantin T, Ponyi A, Orban I, Molnar K, Derfalvi B, Dicso F, et al. National registry of patients with juvenile idiopathic inflammatory myopathies in Hungary--clinical characteristics and disease course of 44 patients with juvenile dermatomyositis. Autoimmunity 2006; 39:223-32.
17. Martin N, Krol P, Smith S, Murray K, Pilkington CA, Davidson JE, et al. A national registry for juvenile dermatomyositis and other paediatric idiopathic inflammatory myopathies: 10 years’ experience; the Juvenile Dermatomyositis National (UK and Ireland) Cohort Biomarker Study and Repository for Idiopathic Inflammatory Myopathies. Rheumatology (Oxford) 2011; 50:137-45.
18. Sato JO, Sallum AM, Ferriani VP, Marini R, Sacchetti SB, Okuda EM, et al. A Brazilian registry of juvenile dermatomyositis: onset features and classification of 189 cases. Clin Exp Rheumatol 2009; 27:1031-8.
19. McCann LJ, Juggins AD, Maillard SM, Wedderburn LR, Davidson JE, Murray KJ, et al. The Juvenile Dermatomyositis National Registry and Repository (UK and Ireland)--clinical characteristics of children recruited within the first 5 yr. Rheumatology (Oxford) 2006; 45:1255-60.
20. Kishi T, Miyamae T, Hara R, Nakajima S, Imagawa T, Mori M, et al. Clinical analysis of 50 children with juvenile dermatomyositis. Mod Rheumatol 2013; 23:311-7.
21. Gardner-Medwin JM, Dolezalova P, Cummins C, Southwood TR. Incidence of Henoch-Schonlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet 2002; 360:1197-202.
22. Ramanan AV, Campbell-Webster N, Ota S, Parker S, Tran D, Tyrrell PN, et al. The effectiveness of treating juvenile dermatomyositis with methotrexate and aggressively tapered corticosteroids. Arthritis Rheum 2005; 52:3570-8.
23. Rouster-Stevens KA, Morgan GA, Wang D, Pachman LM. Mycophenolate mofetil: a possible therapeutic agent for children with juvenile dermatomyositis. Arthritis Care Res (Hoboken) 2010; 62:1446-51.
24. Oddis CV, Reed AM, Aggarwal R, Rider LG, Ascherman DP, Levesque MC, et al. Rituximab in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: a randomized, placebo-phase trial. Arthritis Rheum 2013; 65:314-24.
25. Lai YT, Dai YS, Yen MF, Chen LS, Chen HH, Cooper RG, et al. Dermatomyositis is associated with an increased risk of cardiovascular and cerebrovascular events: a Taiwanese population-based longitudinal follow-up study. Br J Dermatol 2013; 168:1054-9.
26. Eimer MJ, Brickman WJ, Seshadri R, Ramsey-Goldman R, McPherson DD, Smulevitz B, et al. Clinical status and cardiovascular risk profile of adults with a history of juvenile dermatomyositis. J Pediatr 2011; 159:795-801.
27. Wang H, Tang J, Chen X, Li F, Luo J. Lipid profiles in untreated patients with dermatomyositis. J Eur Acad Dermatol Venereol 2013; 27:175-9.
28. Kozu KT, Silva CA, Bonfa E, Sallum AM, Pereira RM, Viana VS, et al. Dyslipidaemia in juvenile dermatomyositis: the role of disease activity. Clin Exp Rheumatol 2013; 31:638-44.
29. Stockton D, Doherty VR, Brewster DH. Risk of cancer in patients with dermatomyositis or polymyositis, and follow-up implications: a Scottish population-based cohort study. Br J Cancer 2001; 85:41-5.
30. Chen YJ, Wu CY, Huang YL, Wang CB, Shen JL, Chang YT. Cancer risks of dermatomyositis and polymyositis: a nationwide cohort study in Taiwan. Arthritis Res Ther 2010; 12:R70.
31. Hill CL, Zhang Y, Sigurgeirsson B, Pukkala E, Mellemkjaer L, Airio A, et al. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. Lancet 2001; 357:96-100.
32. Huang YL, Chen YJ, Lin MW, Wu CY, Liu PC, Chen TJ, et al. Malignancies associated with dermatomyositis and polymyositis in Taiwan: a nationwide population-based study. Br J Dermatol 2009; 161:854-60.
33. Chen YJ, Wu CY, Shen JL. Predicting factors of malignancy in dermatomyositis and polymyositis: a case-control study. Br J Dermatol 2001; 144:825-31.

指導教授

洪炯宗(Jorng-Tzong Horng)

審核日期

2013-10-7

推文