中高齡就業人口罹患帶狀皰疹會增加中風的風險

Middle-Aged Employment Population Suffering From Herpes Zoster Increase Risk of Stroke

陳亮憲(Liang-Sien Chen) ； 詹雅婷(Ya-Ting Jan) ； 黃協賢(Shie-Shian Huang) ； 蘇豐傑(Fong-Jie Su) ； 潘恆之(Heng-Chih Pan) ； 陳昭源(Jau-Yuan Chen)

《中華職業醫學雜誌》 25卷3期 (2018/07) Pp. 193-200

摘要

背景及目的：中風後的殘障和失能對中高齡就業人口的健康有重要的影響，而過去幾年，在不同地區的研究都發現帶狀皰疹發生之後會增加中風的風險。本研究目的是從台灣健保資料庫進行分析台灣地區中高齡就業人口的帶狀皰疹發作後一年內中風發生率的風險估計。方法：本研究運用自我控制-案例系列研究法，從台灣健保資料庫的1997年至2009年的中高齡就業人口內找出同時有診斷為首次發生帶狀皰疹和首次發生中風的所有個案進行分析，我們分析使用條件卜瓦松迴歸計算風險期與控制期的發生率和95％信賴區間。結果：有2258個中高齡就業人口同時有首次發生帶狀皰疹和首次發生中風，其中帶狀皰疹首次發作年齡中位數是58歲。所有個案在皰疹後第5-12週的風險期與控制期相比，中風發生率顯著增加(IR，1.48; 95％ C.I.，1.09-2.01)，但是其他風險期的中風發生率呈現不顯著的相關性。結論：中高齡就業人口在帶狀皰疹發生後的第二、三個月風險期有比較顯著中風的風險。在職業衛生角度而言，帶狀皰疹疫苗施打後，會提供人體產生抗體，進而避免帶狀皰疹發病，而減少發病後中風的發生率。

關鍵字

帶狀皰疹 ； 中風 ； 中高齡就業人口 ； 自我控制病例系列研究法

並列摘要

Background and purpose: Disabilities following stroke have an important impact on the health of the middle-aged employment population. In the past few years, studies in different regions have found that zoster increase risk of stroke. The purpose of this study is to estimate the risk of stroke in one year following zoster in middle-aged employment population in Taiwan. Method: Our study finds all cases diagnosed as having both first-ever zoster and first-ever stroke from middle-aged employment population in Taiwan National Health Research Institute database from 1997 to 2009. We use self-controlled case-series method to analyze the incidence ratios of risk and control periods using the conditional Poisson regression and the 95% confidence interval. Results: The numbers of middle-aged employment population with both first-ever zoster and first-ever stroke are 2258 persons. The median age of first-ever herpes zoster is 58 years old. In all cases, the incidence of stroke is significantly increased compared with the control period at the 5th to 12th week after zoster (IR, 1.48; 95% CI, 1.09-2.01), but the incidence ratios of stroke at other risk periods is not significant. Conclusions: The middle-aged employment population has a significant risk of stroke during the second and third month risk period after herpes zoster. From the perspective of occupational hygiene, zoster vaccine may be used to provide human antibodies to prevent the onset of herpes zoster and further reduce the incidence of stroke following zoster.

並列關鍵字

Herpes Zoster ； Stroke ； Middle-Aged Employment Population ； Self-Controlled Case-Series Study