利用健保資料庫來探討精神病患用藥：從透析的角度

Using national health insurance research database to investigate drug therapy of psychiatric disorders: From the perspective of dialysis

李易都(Yih-Do Li)

指導教授 ： 蔡尚學 ； 楊俊毓

義守大學/醫學院/醫務管理學系/碩士(2016年)

摘要

慢性腎臟疾病是常見的慢性疾病之一，特別是在那些有精神障礙的病患。在許多的醫療情況下，精神障礙的病患經常遭受很多不同的藥物。這些藥物有時可能會導致腎功能惡化。這些藥物有時可能會導致腎功能惡化，進一步需要透析。我們使用健保資料庫分析精神障礙的藥物治療是否導致腎功能惡化。研究藥物治療精神障礙和透析的關係。從2004-2011年間，健保資料庫百萬歸人檔，同時含有精神疾病患者來進行研究。從精神病患族群中，設定「精神疾病」、「年齡」、「性別」、「血液透析」、「使用藥物」和「地區」等變相。推論性統計以卡方檢定、獨立樣本T檢定和邏輯迴歸分析來探討服用精神疾病藥物是否會導致需要透析治療的情形。由服用藥物三個月後跟透析治療來看，服用藥物三個月後有透析治療的有703人，沒有服用藥物有透析治療的有289人；服用藥物三個月後沒有透析治療的有44879人，沒有服用藥物也沒有透析治療的有9045人，從數據中發現在服用藥物三個月後與透析治療在卡方檢定上有顯著差異(P<0.001)。在邏輯迴歸分析中，在單變數，男性會進入透析的風險是女生的1.16倍、服藥三個月以上的風險是沒有服用三個月的0.49倍，有服藥反而比較不會有透析的風險。本研究探討在精神病患上證明用藥與透析相關的腎功能惡化。

關鍵字

精神障礙 ； 透析 ； 健保資料庫 ； 卡方檢定 ； 邏輯迴歸分析

並列摘要

Chronic kidney disease (CKD) is common among patients with chronic disorders, particularly in those with psychiatric disorders. Psychiatric disorders of patients frequently suffer many different medications on many other medical conditions.Many of the medications may on occasion cause deterioration of renal function.These medications may on occasion cause deterioration of renal function, and further requiring dialysis.We use national health insurance research database (NHIRD) analysis, drug therapy of psychiatric disorders are whether lead to deterioration of renal function. To investigate drug treated psychiatric disorders and dialysis the relationship.From 2004 to 2011 years, the NHIRD cohort study by one million people file, containing both psychiatric disorders of patients to study.From the psychiatric disorders population, set the"psychiatric disorders", "Age", "Sex", "Dialysis", "use Medicine", and "Area" disguised.Basic inferential statistics tests that are used include chi-square tests, independent samples t testandLogistic regression analysis to investigate the drug therapy of psychiatric disorders may cause requiring situation of dialysis. From taking medicines were after 3 month that had 703 people with dialysis. Didnot take medicines were after 3 month, that also had 289 people with dialysis.However, taking medicines were after 3 month that had 44879 people without dialysis.Didnot take medicines and dialysis, that also had 9045 people; these data indicated that taking medicines were after 3 month and dialysis had significant correlation bychi-square tests (P<0.001).In logistic regression analysis, a single variable, the menhad dialysis risk of 1.16 timescompared to the girls; taking medicines more than three months had dialysis risk 0.49 times compared to not taking medicines. Our study found thattaking medicinescould be without dialysis risk.This study examines the deterioration of renal functionthat may be proved in patients with psychiatric disorders medications and on dialysis are related

並列關鍵字

psychiatric disorders ； dialysis ； national health insurance research database ； chi-square tests ； logistic regression analysis

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