口腔链球菌感染性内心炎在牙科治疗后高风险个人中:一个嵌套的病例交叉和病例对照研究
Niko Vähäsarja1,2, Bodil Lund1,3, Anders Ternhag4
1Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
EClinicalMedicine
|September 8, 2023
概括
这项研究发现,在高风险患者中,侵入性牙科手术和维里丹斯群菌根感染性内心炎 (VGS-IE) 之间没有明确的联系. 需要对更大的样本大小进行进一步的研究,以确认这种与VGS-IE预防的关联.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 口腔健康 口腔健康
背景情况:
- 维里丹斯集团链球菌感染性内心炎 (VGS-IE) 对患有潜在心脏病的个人构成重大风险.
- 与日常口腔活动相比,侵入性牙科手术 (IDP) 在触发VGS-IE方面的作用尚不清楚.
- 了解这种关联对于为高风险人群制定有效的预防策略至关重要.
研究的目的:
- 调查侵袭性牙科手术 (IDP) 和维里丹斯群菌根感染性内心炎 (VGS-IE) 之间的时间关联.
- 为了比较VGS-IE病例前的IDP频率与高风险队列中的对照.
- 在瑞典全国人口中评估牙科干预后的VGS-IE风险.
主要方法:
- 采用了一个嵌套的病例控制和病例交叉研究设计.
- 使用了瑞典国家队列的76,762名高风险个人 (复杂的先天性心脏病,假发门或以前的IE).
- 关于IE,牙科手术和患者人口统计数据的数据来源于2008年至2018年间的国家注册表.
主要成果:
- 在VGS-IE病例 (4.6%) 和对照病例 (4.1%) (OR=1.22) 之间,在IDP频率上没有发现显著差异.
- 案例交叉分析也显示,与国内流离失所者暂时相关的VGS-IE风险没有增加 (OR=0.89).
- 即使在分析了瑞典牙科抗生素预防指南改变期间的数据后,结果仍然是一致的.
结论:
- 这项研究无法证实高风险个体的侵袭性牙科手术和VGS-IE之间的关联.
- 一小部分VGS-IE病例暂时与国内流离失所者有关,与之前的研究一致.
- 建议进行更大样本规模的研究,以确定或反驳这种关联,并为预防策略提供信息.
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