臺灣尿路結石患者急診利用與季節變化的關聯性: 以全民為基礎的研究

The emergency department utilization of urinary calculi and the association with seasonality in Taiwan : A population-based study

陳怡光(Yi-Kuang Chen)

指導教授 ： 林恆慶

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2007年)

https://doi.org/10.6831/TMU.2007.00037

摘要

目的：利用五年之中尿路結石患者急診就醫資料進行分析，探討臺灣地區尿路結石患者發作與季節變化的關聯性，更進一步確認五種氣象因子中，影響尿路結石發作之主要因子。
方法：從全民健康保險研究資料庫中，挑選出從西元1999年到2003年五年期間，尿路結石患者每個月急診就診率（每十萬人口）的資料。將這些資料依性別及年竛（三群：18-44歲，45-64歲，≧65歲）區分成子群。再以自我廻歸整合移動平均模型（ARIMA）進行分析，以評估尿路結石每月發生率與天氣變化的關聯性及其趨勢走向。
結果：不論性別或年齡之差異，尿路結石患者急診利用的情況，呈現季節性的變化，夏季乃是明顯的高峰期。雖然周遭氣溫、大氣壓力、及日照時數與尿路結石發生率均有統計學上的意義，但在經過自我廻歸整合移動平均模型調整之後，只有周遭氣溫才是主要之影響因子。
結論：這是第一個以全國人民為基礎，進行尿路結石發生率與氣象學因子關聯性之研究，藉此，希望世界上其他地區，不同種族也可以進行頪似資料之蒐集，以探討尿路結石之全球趨勢。
關鍵字：尿路結石；季節變化；氣候

關鍵字

尿路結石 ； 季節變化 ； 氣候

並列摘要

Purpose: Using five-year emergency department visits of urinary calculi data in Taiwan, this study sets out to investigate the hypothesis of a seasonal association with urinary calculi. To clarify the component factors we investigate the relationship with five climatic factors.
Method: National emergency department data from the Taiwan National Health Insurance Research Database (1999 to 2003) provided monthly urinary calculi emergency department visit rates (per 100,000 population). We created subgroups of the urinary calculi cases for gender, and age (3 groups: 18~44, 45~64, and ≥ 65 years). The ARIMA (Auto-Regressive Integrated Moving Average) regression method was performed to evaluate the effects of climatic factors and monthly urinary calculi attack rates after adjusting for the time-trend effect.
Results: Seasonality with a summer peak was evident in emergency department utilization of urinary calculi regardless of gender or age. Although significant associations were found between ambient temperature, atmospheric pressure, hours of sunshine and the urinary calculi incidence rates for total population, ambient temperature was the major factor which was positively associated with urinary calculi incidence after adjustment for trend and seasonality.
Conclusion:This is the first nationwide population-based study to investigate the dependence of urinary calculi rates on meteorological conditions. We recommend data be collected from other regions and among other ethnic groups to determine the general pattern worldwide.

Key words: urinary calculi; seasonality; climate

並列關鍵字

urinary calculi ； seasonality ； climate

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