葡萄膜炎對角膜病變發展的影響：臺灣族群之世代追蹤研究

Effect of Uveitis on the Development of Keratopathy: A Population-Based Cohort Study

粘展瑋(Chan-Wei Nien)

指導教授 ： 楊順發

中山醫學大學/醫學院/醫學研究所/博士(2020年)

https://doi.org/10.6834/csmu202000039

摘要

研究目的：
本研究旨在通過使用台灣國家健康保險研究數據庫(National Health Insurance Research Database；NHIRD) 評估葡萄膜炎對各種角膜病變發展的影響。

研究方法及資料：
從台灣國家健康保險研究數據庫所登記數據裡，隨機抽取約100萬位患者。篩選排除後，經眼科醫師診斷為葡萄膜炎的患者進入研究組。研究組中，每位患者的年齡和性別均與作為對照組的4個非葡萄膜炎個體相匹配。除了角膜病變外，多變量分析還包括其他可能危險因子和藥物，並且還分析不同亞型葡萄膜炎對角膜病變發展的影響。

研究結果：
總共納入4773位葡萄膜炎患者(2662位男性和2111位女性)和19092位非葡萄膜炎患者(10648位男性和8444位女性)。在研究組中有406例角膜病變事件，在對照組中有764例角膜病變事件。調整後，角膜病變發生率在研究組較高(調整後危險比adjusted hazard ratio [aHR]：1.772)，累積概率也較高(cumulative probability，p <0.0001)。 對於亞組分析，前葡萄膜炎(aHR = 1.765)和全葡萄膜炎(aHR = 3.386)顯著增加發生角膜病變的風險。此外，在研究組中，男性相對於女性，有比較高的危險比發展角膜病變。

結論與建議：
葡萄膜炎的存在明顯增加罹患角膜病變的風險。

關鍵字

葡萄膜炎 ； 角膜病變 ； 角膜 ； 族群研究

並列摘要

Objective：
The purpose of this study was to evaluate the effect of uveitis on the development of various keratopathies via the use of the National Health Insurance Research Database (NHIRD) in Taiwan.

Methods and Materials：
Approximately 1 million patients were randomly sampled from the registry of the NHIRD. Patients diagnosed with uveitis by ophthalmologists were enrolled in the study group after exclusion. Each individual in the study group was age and sex matched to four nonuveitis individuals who serve as the control group. In addition to keratopathy, other possible risk factors and medications were included in the multivariate model, and the effects of different subtypes of uveitis for developing keratopathies were also analyzed.

Results：
A total of 4773 uveitis patients (2662 male and 2111 female) and 19,092 non-uveitis patients (10,648 male and 8444 female) were enrolled. There were 406 events of keratopathy in the study group, and another 764 events occurred in the control group. A higher incidence rate was found in the study group after adjustment (adjusted hazard ratio [aHR]: 1.772), with a greater cumulative probability (p < 0.0001). For the subgroup analysis, anterior uveitis (aHR = 1.765) and panuveitis (aHR = 3.386) increased the risk of developing keratopathies. Moreover, male sex was associated with a higher aHR than female sex for developing keratopathies in the study group.

Conclusion and Suggestion：
The presence of uveitis significantly elevates the risk for developing keratopathy.

並列關鍵字

uveitis ； keratopathy ； cornea ； population-based

參考文獻

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