肺结核治愈后糖尿病、心肌梗死和中风的发病情况：2002-2013 年台湾地区肺结核患者的回顾性队列分析。
Post-tuberculosis incidence of diabetes, myocardial infarction, and stroke: Retrospective cohort analysis of patients formerly treated for tuberculosis in Taiwan, 2002-2013.
机构信息
Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
出版信息
Int J Infect Dis. 2019 Jul;84:127-130. doi: 10.1016/j.ijid.2019.05.015. Epub 2019 May 11.
OBJECTIVES
To estimate the incidence of diabetes, acute myocardial infarction (AMI), and stroke; and to determine factors associated with diabetes, AMI, and stroke incidence among patients previously treated for tuberculosis (TB) disease.
METHODS
A retrospective cohort study was conducted among non-pediatric TB patients registered in the Taiwan National Health Insurance Research Database (NHIRD) from 2002-2013. Diabetes, AMI, and stroke incidence were defined by International Classification of Diseases (ICD)-9 codes, drug prescriptions, and records of patient's clinic visits. Cox proportional hazard models were used to estimate the hazard rate ratio (HR) of incident diabetes, AMI, and stroke.
RESULTS
From 2002-2013, there were 157,444 patients treated for TB registered in NHIRD. Among 129,453 patients with no prior history of diabetes, the age-adjusted incidence rate (IR) of diabetes was 3.85 (95%CI 3.70-4.01) per 1000 person-years. Among 143,646 patients with no prior history of AMI, the age-adjusted IR of AMI as 3.26 (95%CI 3.13-3.40). Among 118,774 patients with no prior history of stroke, the age-adjusted IR of stroke was 16.08 (95%CI 15.76-16.32).
CONCLUSIONS
Chronic non-communicable disease risk factors like dyslipidemia, hypertension, and chronic kidney disease diagnosed before time of TB diagnosis were predictive of diabetes, AMI, and stroke incidence.
目的
评估糖尿病、急性心肌梗死（AMI）和中风的发病率；并确定既往结核病（TB）患者中与糖尿病、AMI 和中风发病率相关的因素。
方法
对 2002 年至 2013 年在台湾全民健康保险研究数据库（NHIRD）中登记的非儿科 TB 患者进行回顾性队列研究。糖尿病、AMI 和中风的发病率通过国际疾病分类（ICD）-9 代码、药物处方和患者就诊记录来定义。采用 Cox 比例风险模型估计新发糖尿病、AMI 和中风的风险比（HR）。
结果
2002 年至 2013 年，NHIRD 登记了 157444 例 TB 治疗患者。在 129453 例无糖尿病既往史的患者中，糖尿病的年龄调整发病率（IR）为 3.85（95%CI 3.70-4.01）/1000 人年。在 143646 例无 AMI 既往史的患者中，AMI 的年龄调整 IR 为 3.26（95%CI 3.13-3.40）。在 118774 例无中风既往史的患者中，中风的年龄调整 IR 为 16.08（95%CI 15.76-16.32）。
结论
在 TB 诊断前诊断出的血脂异常、高血压和慢性肾脏病等慢性非传染性疾病危险因素预测了糖尿病、AMI 和中风的发病率。
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