在初级保健中诊断的疾病和症状与随后的多发性硬化症的特定风险之间的关联
Octave Guinebretiere1, Thomas Nedelec1, Laurene Gantzer1
1From the Sorbonne Université (O.G., T.N., S.D., C.L.), Paris Brain Institute-ICM, Inserm, CNRS, Inria; Cegedim R&D (L.G., B.B.L.), Boulogne-Billancourt; and Department of Neurology (C.L.), CIC Neurosciences, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, France.
Neurology
|December 5, 2023
概括
包括抑郁症和便秘在内的五种健康状况与多发性硬化症 (MS) 诊断的更高风险有关. 然而,这些症状并不特定于MS,也出现在其他自身免疫性疾病中.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 流行病学 流行病学
背景情况:
- 之前的研究表明,多发性硬化症 (MS) 的潜在前兆,其特征是诊断前几年出现非特异性症状和增加医疗保健利用率.
- 这项研究调查了在初级保健中诊断的各种疾病和症状与随后的多发性硬化症风险之间的联系.
研究的目的:
- 以不可知的方式评估初级保健诊断与多发性硬化症 (MS) 风险之间的关联.
- 将这些关联与其他自身免疫性疾病,特别是狼和克罗恩病 (CD) 的关联进行比较.
主要方法:
- 一项病例控制研究使用了来自英国和法国的电子健康记录 (健康改善网络数据库).
- 在诊断前5年和诊断后5年内,评估了113种疾病/症状和MS诊断之间的关联.
- 患有多发性硬化症的患者与没有多发性硬化症的对照组以及患有CD和狼的患者进行了比较.
主要成果:
- 十二个ICD-10代码与对照组相比,与多发性硬化症风险有显著关联.
- 在排除神经系统症状代码后,五个ICD-10代码仍然与MS显著相关:抑郁症,性功能障碍,便秘,囊炎和尿路感染.
- 这五种疾病也与狼和疾病相关,表明MS缺乏特异性.
结论:
- 五种健康状况与随后的多发性硬化症诊断有关,可能代表预发性或早期症状.
- 这些确定的疾病缺乏MS的特异性,因为它们与其他自身免疫性疾病 (如狼和CD) 的前兆症状重叠.
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