以台灣全民健保資料庫分析牙周治療與肺炎發生率的相關性研究

The Association of Periodontal Treatment and Pneumonia from Taiwanese National Health Insurance Research Database

孫奕貞(Yih-Jane Suen)

指導教授 ： 張育超

中山醫學大學/口腔醫學院/牙醫學系/碩士(2020年)

https://doi.org/10.6834/csmu202000149

摘要

肺炎是一種常見的呼吸道傳染病，涉及肺實質的發炎。牙周疾病是廣泛的被認為與肺炎有關。然而，肺炎患者的牙周治療與臨床肺部感染結果之間的關係仍未確定。這項研究的目的是調查全台灣人口中牙周治療與肺炎事件風險之間的關係。研究使用來自台灣國民健康保險研究資料庫的數據進行了全國性的世代研究。選擇2001年至2012年接受牙周治療的49,400例慢性牙周炎患者。此外，根據年齡，性別，月收入，城市化程度和合併症，在傾向得分匹配後，從普通人群中隨機選擇了49,400名沒有牙周疾病的健康個體。採用Cox比例風險回歸分析來評估牙周治療組別和對照組別之間的肺炎風險比。牙周治療組和對照組的平均年齡分別為44.25±14.82歲和44.15±14.5歲。牙周治療組和對照組的追蹤時間分別為7.66年和7.41年。我們在對照組和牙周治療組中分別發現了2,504和1,922例新診斷為肺炎的患者。 結果由Kaplan-Meier圖顯示，在牙周治療組的12年追蹤期內，肺炎的累積發生率明顯降低，且具有統計學上之意義(p <0.001)。總結，基於這項全國人口學的研究表明，進行牙周病治療的患者患，其有肺炎的風險顯著低於普通人群。

關鍵字

肺炎 ； 牙周病治療 ； 慢性牙周炎 ； 全國人口 ； 世代研究 ； 台灣

並列摘要

Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2,504 and 1,922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan–Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.

並列關鍵字

pneumonia ； periodontal treatment ； chronic periodontitis ； nationwide population ； cohort study ； Taiwan

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