慢性鼻竇炎術後引發青光眼台灣全國人口之世代研究

The Development of Glaucoma after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

周兆峰(Siu-Fung Chau)

指導教授 ： 周明智

中山醫學大學/醫學院/醫學研究所/博士(2022年)

https://doi.org/10.6834/csmu202200210

摘要

研究目的
眼睛和鼻竇是相鄰的結構，相關文獻研究提出青光眼疾病與慢性鼻竇炎相關。國外有文獻資料顯示使用功能性內視鏡手術治療慢性鼻竇炎對眼壓的影響不大，但亦有持相反結論的文獻。
本篇討論是利用台灣全民健保資料庫建立的研究族群，探究使用功能性內視鏡手術治療慢性鼻竇炎之族群引發青光眼發生之相關性。

方法
利用台灣全民健保資料庫抽樣產生的抽樣檔--2005年(LHID 2005)找出2000-2016年因慢性鼻竇炎需手術之患者引發青光眼之族群(共6506病例)，經過篩選標準後以一比四的比例(26024病例)配對出非慢性鼻竇炎之族群，同時收集其合併症資料作出相關分析。

結果
研究組和對照組分別為108例294例青光眼發生，研究組的調整後危險比(adjusted hazard ratio)明顯更高1.291倍。(95％可信區間：1.031-1.615)。綜合本研究，在調整了多種潛在危險因素後，需手術治療之慢性鼻竇炎(CRS)病患在接受功能性內視鏡鼻竇手術 (FESS) 後可導致顯著的青光眼發生，並與慢性鼻竇炎(CRS) 患病期間相關。

關鍵字

青光眼 ； 慢性鼻竇炎

並列摘要

This study investigates the development of glaucoma in subjects with surgery-indicated chronic rhinosinusitis (CRS) by the use of the National Health Insurance Research Database in Taiwan.
Individuals that received the functional endoscopic sinus surgery (FESS) with a diagnostic code of CRS were regarded as surgery-indicated CRS and enrolled in the study group. Four non-CRS patients were age- and gender-matched to each patient in the study group. The exclusion criteria included legal blindness, ocular tumor, history of eyeball removal, and previous glaucoma.
The outcome was regarded as the development of glaucoma, and conditional logistic regression was used for the statistical analysis, which involved multiple potential risk factors in the multivariate model. A total of 6506 patients with surgery-indicated CRS that received FESS and another 26,024 non-CRS individuals were enrolled after exclusion. The age and gender distributions were identical between the two groups due to matching. There were 108 and 294 glaucoma events in the study group and control group, respectively, during the follow-up period, and the study group had a significantly higher adjusted hazard ratio (1.291, 95% confidential interval: 1.031–1.615). The cumulative probability analysis also revealed a correlation between the occurrence of glaucoma and the CRS disease interval. In the subgroup analysis, the chance of developing open-angle glaucoma and normal-tension glaucoma was significantly higher in the study group than in the control group.
In conclusion, the existence of surgery-indicated CRS is a significant risk factor for the development of glaucoma, which correlated with the disease interval

並列關鍵字

glaucoma ； chronic rhinosinusitis

參考文獻

參考文獻

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