反中性细胞质抗体相关的血管炎和发展偶发性结核病的风险:一个基于人口的队列研究
Shan-Ho Chan1, Ming-Feng Li1,2, Shih-Hsiang Ou3,4
1Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan.
Medicina (Kaunas, Lithuania)
|November 25, 2023
概括
被诊断为抗中性人细胞质抗体相关性血管炎 (AAV) 的患者面临显著更高的结核病 (TB) 发病风险. 这种风险在诊断后的两年和女性患者中特别高.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
背景情况:
- 抗中性细胞质抗体相关血管炎 (AAV) 治疗包括免疫抑制,增加对结核病 (TB) 等感染的易感性.
- 了解AAV患者的偶然结核病风险对于有效的管理和预防策略至关重要.
研究的目的:
- 在诊断出抗中性细胞质抗体相关血管炎 (AAV) 后,调查偶然结核病 (TB) 的风险.
主要方法:
- 基于人口的回顾性队列研究,使用台湾国家医疗保险研究数据库.
- 包括2000-2012年新诊断的颗粒状多炎或微观多炎的患者.
- 倾向性得分匹配和Cox比例危险模型用于评估AAV患者的结核病风险.
主要成果:
- 在AAV患者中,偶发性结核病的风险增加了48% (调整HR 1.48).
- 结核病的风险在AAV诊断后的头两年内是最高的,风险增加了91% (调整后HR 1.91).
- 与没有AAV的女性相比,女性AAV患者患结核病的风险高3.24倍 (调整HR为3.24).
结论:
- AAV患者患结核病的风险较高,特别是在诊断后两年内.
- 女性AAV患者患结核病的风险要大得多.
- 建议对所有AAV患者进行密切的结核病监测,特别是女性和诊断后最初两年的患者,因为可能存在错误分类和高估AAV病例.
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