Statins與Aspirin對於年長的第二型糖尿病患者罹患失智症的影響:以台灣全人口基礎的前瞻式世代研究

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許啟昌(Chi-Chang Hsu) 查詢紙本館藏

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資訊工程學系在職專班

論文名稱

Statins與Aspirin對於年長的第二型糖尿病患者罹患失智症的影響:以台灣全人口基礎的前瞻式世代研究
(Effects of statins and aspirin on dementia among elder type 2 diabetes mellitus patients: A population-based prospective cohort study in Taiwan)

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摘要(中)

失智症不是一種立即致命性的疾病，但隨著病情的惡化，不只病人的生活變得不便，而且會逐漸加重家屬的負擔。第二型糖尿病在台灣的老年人口中是相當常見的慢性疾病，而且它也是失智症的一個危險因子。所以如果存在某些藥物治療可以降低第二型糖尿病病患得到失智症的潛在風險，不僅可以釋放國家醫療系統的資源給其它疾病，也可以幫助病患享有較好的生活品質。我們研究的對象是在台灣的50歲以上的第二型糖尿病患，藉由檢驗病患在1998與2008間的診斷資料，來觀察statins與aspirin對於失智症的影響。最後，我們發現常態性服用statins的病患，每日平均服用劑量小於10毫克，可以降低得到阿茲海默症的風險。而常態性服用aspirin的病患，每日平均服用劑量介於100到200毫克之間，可以降低得到阿茲海默症的風險，但每日平均服用劑量大於300毫克，則會增加罹患非阿茲海默失智症的風險，若大於600毫克，則會增加罹患阿茲海默症的風險。

摘要(英)

Dementia is not an instant deathful disease. However, in pace with its progression, not only patient’s life becomes inconvenient, but also imposes family’s burden. Type 2 diabetes mellitus (T2DM) is a risk factor of dementia and it’s a common chronic disease among elder Taiwanese. If there are existed some medications that can reduce the potential risk among T2DM patients, it will not only help release national healthcare resource to other diseases but also help patients get better lives quality. In this study, our target cohort was T2DM patients whose ages greater than 50 in Taiwan. We examined patient’s clinical records between 1998 and 2008 to see the effects of statins and aspirin on dementia. Finally, we found statins can significantly reduce the risk of Alzheimer’s disease (AD) among T2DM patients with mean daily dose (MDD) < 10mg. Aspirin also significantly decreased the risk of AD with MDD between 100 and 200mg. However, aspirin significantly increased the risk of AD with MDD ≧ 600mg and the risk of non-Alzheimer dementia with MDD ≧ 300mg.

關鍵字(中)

★ 第二型糖尿病
★ 失智症
★ 阿茲海默症

關鍵字(英)

★ T2DM
★ dementia
★ Alzheimer’s disease
★ statin
★ aspirin

論文目次

摘要 .............................................. i
Abstract .......................................... ii
誌謝 .............................................. iii
Table of Contents ................................. iv
List of Figures ................................... vi
List of Tables .................................... vii
Chapter 1 Introduction ............................ 1
1.1 Background .................................... 1
1.2 Motivation .................................... 3
1.3 Research Goal ................................. 4
1.4 Related Works ................................. 4
Chapter 2 Materials and Methods ................... 7
2.1 Data Source.................................... 7
2.2 T2DM and Dementia Assessment .................. 7
2.3 Drugs Regular User Definition ................. 8
2.4 Study Cohort Selection ........................ 8
2.5 Confounding Factors ........................... 10
2.6 Statistical Analysis .......................... 10
Chapter 3 Statins Effects ......................... 12
3.1 Study Cohorts Selection ....................... 12
3.2 Demographic Characteristics ................... 13
3.3 Incidence Rate of Dementia .................... 15
3.4 Risks of Dementia ............................. 17
3.5 Kaplan-Meier Dementia-Free Survival Curves .... 23
Chapter 4 Aspirin Effects ......................... 25
4.1 Study Cohorts Selection ....................... 25
4.2 Demographic Characteristics ................... 26
4.3 Incidence Rate of Dementia .................... 28
4.4 Risks of Dementia ............................. 29
4.5 Kaplan-Meier Dementia-Free Survival Curves .... 37
Chapter 5 Discussion .............................. 40
Chapter 6 Conclusion .............................. 45
References ........................................ 46
Appendix I Charlson-Deyo Comorbidity Index ........ 51

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指導教授

洪炯宗(Jorng-Tzong Horng)

審核日期

2013-10-15

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