博碩士論文 101552007 詳細資訊




以作者查詢圖書館館藏 以作者查詢臺灣博碩士 以作者查詢全國書目 勘誤回報 、線上人數:14 、訪客IP:54.172.234.236
姓名 邱鼎文(Ding-Wen Chiu)  查詢紙本館藏   畢業系所 資訊工程學系在職專班
論文名稱 患有慢性阻塞肺病會增加得到敗血症的風險: 以台灣全人口基礎的前瞻式世代研究
(Increased risk of sepsis among patients with chronic obstructive pulmonary disease patients: A population-based prospective cohort study in Taiwan)
相關論文
★ 應用嵌入式系統於呼吸肌肉群訓練儀之系統開發★ 勃起障礙與缺血性心臟病的雙向研究: 以台灣全人口基礎的世代研究
★ 使用穿戴式裝置分析心律變異及偵測心律不整之應用程式★ 建立一個自動化分析系統用來分析任何兩種疾病之間的關聯性透過世代研究設計以及使用承保抽樣歸人檔
★ 青光眼病患併發糖尿病,使用Metformin及Sulfonylurea治療得到中風之風險:以台灣人口為基礎的觀察性研究★ 利用組成識別和序列及空間特性構成之預測系統來針對蛋白質交互作用上的特殊區段點位進行分析及預測辨識
★ 新聞語意特徵擷取流程設計與股價變化關聯性分析★ 藥物與疾病關聯性自動化分析平台設計與實作
★ 建立財務報告自動分析系統進行股價預測★ 建立一個分析疾病與癌症關聯性的自動化系統
★ 基於慣性感測器虛擬鍵盤之設計與實作★ 一個醫療照護監測系統之實作
★ 應用手機開發手握球握力及相關資料之量測★ 利用關聯分析全面性的搜索癌症關聯疾病
★ 全面性尋找類風濕性關節炎之關聯疾病★ 利用機器學習法估算台灣無測站區域之PM2.5濃度
檔案 [Endnote RIS 格式]    [Bibtex 格式]    [相關文章]   [文章引用]   [完整記錄]   [館藏目錄]   [檢視]  [下載]
  1. 本電子論文使用權限為同意立即開放。
  2. 已達開放權限電子全文僅授權使用者為學術研究之目的,進行個人非營利性質之檢索、閱讀、列印。
  3. 請遵守中華民國著作權法之相關規定,切勿任意重製、散佈、改作、轉貼、播送,以免觸法。

摘要(中) 慢性阻塞性肺疾病(COPD)是一種常見的健康問題,有很高的發病率及死亡率,其特
徵在於氣流受限和不完全可逆的。敗血症是一種全身性的炎症反應,而主要發生原因是受
到細菌的感染。患有敗血症患者死亡率在全球高達30%到60%,而在最近的一項研究中顯
示,慢性阻塞性肺疾病的患者容易感染肺炎,肺炎和敗血症是有密切關聯的,嚴重感染肺
炎的患者最終都會導致敗血症的發生,因而肺炎可能是慢性阻塞性肺疾病造成敗血症之間
的中介,而肺炎可能是其中一個非常重要關鍵因素之一,因此我們從全民健康保險研究資
料庫抓取100 歲以下的新發慢性阻塞性肺疾病病患,再來排除一些會影響我們研究的病患,
然後評估慢肺炎及共病是否會影響得到敗血症的風險,最後我們分析出慢性阻塞性肺疾病
的患者得到敗血症的風險是比較高的(HR=1.50,95% CI=1.42-1.59),而在我們控制了肺
炎之後,得到敗血症的風險會降低(HR=1.21,95% CI =1.15-1.28),所以肺炎是導致敗血
症的一個非常重要的關鍵因素。然而,較年長的慢性阻塞性肺疾病患者會比年輕的患者有
更高的風險得到敗血症,尤其是年齡在60 歲以上的患者。
摘要(英) Chronic obstructive pulmonary disease (COPD) is a major health problem and a leading
cause of morbidity and mortality, which is characterized by airflow limitation that is progressive
and not fully reversible. Sepsis is a systemic inflammatory response to infection. The fatality rate
of patients with sepsis has continues as high as 30%-60% worldwide. In a recent study, COPD
are at increased risk of contracting pneumonia, pneumonia and sepsis are interrelated because
severe cases of pneumonia can eventually lead to sepsis. Thus pneumonia is acts as an
intermediary between COPD and the sepsis, it is an important key factor. Thus, we select ≦100
years newly COPD patients from National Health Insurance Research Database (NHIRD),
exclude some patients who affect our study and evaluate the effects of comorbidities or
pneumonia with COPD on the sepsis risk. Finally, we analyzed the patients with COPD had an
increased risk for sepsis in this cohort (HR=1.50, 95% CI=1.42-1.59), after controlling for
pneumonia, the risk was attenuated (HR=1.21, 95% CI =1.15-1.28). Pneumonia was a very
strong factor of sepsis. However, the elderly COPD patients were at a higher hazard for sepsis
than the younger, especially in the group aged >60 years.
關鍵字(中) ★ 敗血症
★ 慢性阻塞肺病
關鍵字(英) ★ sepsis
★ chronic obstructive pulmonary disease
論文目次 摘要 ...................................................................................................................................................i
ABSTRACT .................................................................................................................................... ii
Table of Contents ........................................................................................................................... iii
List of Figures ................................................................................................................................... v
List of Tables ...................................................................................................................................vi
Chapter 1 Introduction ...................................................................................................................... 1
Chapter 2 Related Works .................................................................................................................. 3
2.1 Chronic Obstructive Pulmonary Disease ......................................................................... 3
2.2 COPD and Sepsis ............................................................................................................ 4
Chapter 3 Materials and Methods ..................................................................................................... 6
3.1 Data Source ..................................................................................................................... 6
3.2 Study Design ................................................................................................................... 6
3.3 Sepsis Exposure ............................................................................................................... 9
3.4 Confounding Factors ....................................................................................................... 9
3.5 Statistical Analysis .......................................................................................................... 9
Chapter 4 Results ............................................................................................................................ 11
4.1 Demographic Characteristics ......................................................................................... 11
4.2 Incidence Rate and Risk of Sepsis between Two Cohorts ............................................ 14
4.3 Incidence Rate and Risk of Pneumonia between Two Cohorts .................................... 17
4.4 Incidence Rate and Risk of Bacteremia between Two Cohorts .................................... 19
4.5 Relative Risk of Sepsis among COPD Cohorts ............................................................. 21
4.6 Incidence Rate and Risk for Age Groups of Sepsis between Two Cohorts .................. 22
4.7 Theophylline Effects ..................................................................................................... 28
4.8 Kaplan-Meier Sepsis-Free Curves ................................................................................. 31
4.9 Kaplan-Meier Pneumonia-Free Curves ......................................................................... 32
4.10 Kaplan-Meier Bacteremia-Free Curves ......................................................................... 33
Chapter 5 Discussion ...................................................................................................................... 34
iv
References ...................................................................................................................................... 37
參考文獻 References
1. Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global Strategy for
the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary
Disease. 2010: p. Available from: http://www.goldcopd.org.
2. Punekar, Y.S., et al., Cost-effectiveness of umeclidinium/vilanterol combination
therapy compared to tiotropium monotherapy among symptomatic patients with
chronic obstructive pulmonary disease in the UK. Cost Effectiveness and Resource
Allocation, 2015. 13(1): p. 1-8.
3. Chan, T.C., et al., Geographic disparity in chronic obstructive pulmonary disease
(COPD) mortality rates among the Taiwan population. PLoS One, 2014. 9(5): p.
e98170.
4. Wu, W.F., et al., Prevalence, severity, and time trends of allergic conditions in
6-to-7-year-old schoolchildren in Taipei. J Investig Allergol Clin Immunol, 2011.
21(7): p. 556-62.
5. Nishioka, M., et al., Fibroblast-epithelial cell interactions drive
epithelial-mesenchymal transition differently in cells from normal and COPD patients.
Respir Res, 2015. 16(1).
6. Lee, Y.M., Chronic obstructive pulmonary disease: respiratory review of 2014. Tuberc
Respir Dis (Seoul), 2014. 77(4): p. 155-60.
7. Cao, Z., et al., microRNA-183 down-regulates the expression of BKCaβ1 protein that
is related to the severity of chronic obstructive pulmonary disease. Hippokratia, 2014.
18(4): p. 328-32.
8. Wei, L., et al., Comprehensive analysis of gene-expression profile in chronic
obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2015. 10: p. 1103-9.
9. Chung, K.F., Cytokines as targets in chronic obstructive pulmonary disease. Curr
Drug Targets, 2006. 7(6): p. 675-81.
10. Barnes, P.J., Mechanisms in COPD: differences from asthma. Chest, 2000. 117(2
Suppl): p. 10s-4s.
11. Liu, D., et al., Prognostic Value of Procalcitonin in Adult Patients with Sepsis: A
Systematic Review and Meta-Analysis. PLoS One, 2015. 10(6).
12. Dombrovskiy, V.Y., et al., Rapid increase in hospitalization and mortality rates for
severe sepsis in the United States: a trend analysis from 1993 to 2003. Crit Care Med,
2007. 35(5): p. 1244-50.
13. Iskander, K.N., et al., Sepsis: multiple abnormalities, heterogeneous responses, and
evolving understanding. Physiol Rev, 2013. 93(3): p. 1247-88.
14. Robertson, C.M. and C.M. Coopersmith, The systemic inflammatory response
syndrome. Microbes and Infection, 2006. 8(5): p. 1382-1389.
15. Remick, D.G., Pathophysiology of Sepsis. Am J Pathol, 2007. 170(5): p. 1435-44.
16. Zheng, G., et al., Experimental treatments for mitochondrial dysfunction in sepsis: A
narrative review. J Res Med Sci, 2015. 20(2): p. 185-95.
17. Spronk, P.E., V.S. Kanoore-Edul, and C. Ince, Microcirculatory and Mitochondrial
Distress Syndrome (MMDS): A New Look at Sepsis, in Functional Hemodynamic
Monitoring, M. Pinsky and D. Payen, Editors. 2005, Springer Berlin Heidelberg. p.
47-67.
18. Farr, B.M., et al., Risk factors for community-acquired pneumonia diagnosed upon
hospital admission. British Thoracic Society Pneumonia Study Group. Respir Med,
2000. 94(10): p. 954-63.
38
19. Lange, P., J. Vestbo, and J. Nyboe, Risk factors for death and hospitalization from
pneumonia. A prospective study of a general population. Eur Respir J, 1995. 8(10): p.
1694-8.
20. Wang, H.E., et al., Long-term mortality after community-acquired sepsis: a
longitudinal population-based cohort study. BMJ Open, 2014. 4(1): p. e004283.
21. Hasselbacher, D.A., D.M. Mannino, and R. Berger, Patients with chronic obstructive
pulmonary disease are at higher risk of sepsis Chest, 2005. 128(4_MeetingAbstracts):
p. 378S-b-379S.
22. Benfield, T., P. Lange, and J. Vestbo, COPD stage and risk of hospitalization for
infectious disease. Chest, 2008. 134(1): p. 46-53.
23. Liao, K.M., et al., Dementia Increases Severe Sepsis and Mortality in Hospitalized
Patients With Chronic Obstructive Pulmonary Disease. Medicine (Baltimore), 2015.
94(23): p. e967.
24. Fu, A.Z., et al., Lower 30-day readmission rates with roflumilast treatment among
patients hospitalized for chronic obstructive pulmonary disease. Int J Chron Obstruct
Pulmon Dis, 2015. 10: p. 909-15.
25. Sen, E., et al., Adherence to GOLD guideline treatment recommendations among
pulmonologists in Turkey. Int J Chron Obstruct Pulmon Dis, 2015. 10: p. 2657-63.
26. Dietrich, K., et al., Glucocorticoid therapy and risk of bladder cancer. Br J Cancer,
2009. 101(8): p. 1316-20.
27. Severi, G., et al., Asthma, asthma medications, and prostate cancer risk. Cancer
Epidemiol Biomarkers Prev, 2010. 19(9): p. 2318-24.
28. Karagas, M.R., et al., Non-melanoma skin cancers and glucocorticoid therapy. Br J
Cancer, 2001. 85(5): p. 683-6.
29. Hwang, C.Y., et al., Cancer risk in patients with allergic rhinitis, asthma and atopic
dermatitis: a nationwide cohort study in Taiwan. Int J Cancer, 2012. 130(5): p. 1160-7.
30. Shahraz, S., et al., Use of Systematic Methods to Improve Disease Identification in
Administrative Data: The Case of Severe Sepsis. Med Care, 2014.
31. Tsai, T.Y., et al., Increased risk and related factors of depression among patients with
COPD: a population-based cohort study. BMC Public Health, 2013. 13: p. 976.
32. Yamauchi, Y., et al., Comparison of clinical characteristics and outcomes between
aspiration pneumonia and community-acquired pneumonia in patients with chronic
obstructive pulmonary disease. BMC Pulm Med, 2015. 15: p. 69.
33. Merino-Sanchez, M., et al., Prognosis in patients with pneumonia and chronic
obstructive pulmonary disease. Arch Bronconeumol, 2005. 41(11): p. 607-11.
34. Restrepo, M.I., et al., Impact of macrolide therapy on mortality for patients with
severe sepsis due to pneumonia. Eur Respir J, 2009. 33(1): p. 153-9.
35. Baker, E.H., et al., Hyperglycaemia is associated with poor outcomes in patients
admitted to hospital with acute exacerbations of chronic obstructive pulmonary
disease. Thorax, 2006. 61(4): p. 284-289.
36. Pauwels, R.A., et al., Global Strategy for the Diagnosis, Management, and Prevention
of Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and
Critical Care Medicine, 2001. 163(5): p. 1256-1276.
37. Eichacker, P.Q., C. Natanson, and R.L. Danner, Surviving sepsis--practice guidelines,
marketing campaigns, and Eli Lilly. N Engl J Med, 2006. 355(16): p. 1640-2.
38. Rathour, S., et al., PIRO concept: staging of sepsis. J Postgrad Med, 2015. 61(4): p.
235-42.
39. Xue, M., et al., Diagnostic and prognostic utility of tissue factor for severe sepsis and
sepsis-induced acute lung injury. J Transl Med, 2015. 13: p. 172.
40. Undas, A., et al., Thrombin generation in chronic obstructive pulmonary disease:
39
dependence on plasma factor composition. Thromb Res, 2011. 128(4): p. e24-8.
41. Sabit, R., et al., The effects of hypoxia on markers of coagulation and systemic
inflammation in patients with COPD. Chest, 2010. 138(1): p. 47-51.
42. Dursunoglu, N., et al., Severity of coronary atherosclerosis in patients with COPD.
Clin Respir J, 2015.
43. Maclay, J.D., et al., Vascular Dysfunction in Chronic Obstructive Pulmonary Disease.
American Journal of Respiratory and Critical Care Medicine, 2009. 180(6): p.
513-520.
44. Devereux, G., et al., Use of low-dose oral theophylline as an adjunct to inhaled
corticosteroids in preventing exacerbations of chronic obstructive pulmonary disease:
study protocol for a randomised controlled trial. Trials, 2015. 16: p. 267.
45. Adanin, S., et al., Inhibiting adenosine deaminase modulates the systemic
inflammatory response syndrome in endotoxemia and sepsis. Am J Physiol Regul
Integr Comp Physiol, 2002. 282(5): p. R1324-32.
46. Jenne, J.W., What role for theophylline? Thorax, 1994. 49(2): p. 97-100.
指導教授 洪炯宗(Jorng-Tzong Horng) 審核日期 2016-1-29
推文 facebook   plurk   twitter   funp   google   live   udn   HD   myshare   reddit   netvibes   friend   youpush   delicious   baidu   
網路書籤 Google bookmarks   del.icio.us   hemidemi   myshare   

若有論文相關問題,請聯絡國立中央大學圖書館推廣服務組 TEL:(03)422-7151轉57407,或E-mail聯絡  - 隱私權政策聲明