患有慢性阻塞肺病會增加得到敗血症的風險: 以台灣全人口基礎的前瞻式世代研究;Increased risk of sepsis among patients with chronic obstructive pulmonary disease patients: A population-based prospective cohort study in Taiwan

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题名:	患有慢性阻塞肺病會增加得到敗血症的風險: 以台灣全人口基礎的前瞻式世代研究;Increased risk of sepsis among patients with chronic obstructive pulmonary disease patients: A population-based prospective cohort study in Taiwan
作者:	邱鼎文;Chiu,Ding-Wen
贡献者:	資訊工程學系在職專班
关键词:	敗血症;慢性阻塞肺病;sepsis;chronic obstructive pulmonary disease
日期:	2016-01-29
上传时间:	2016-03-17 20:44:58 (UTC+8)
出版者:	國立中央大學
摘要:	慢性阻塞性肺疾病（COPD）是一種常見的健康問題，有很高的發病率及死亡率，其特徵在於氣流受限和不完全可逆的。敗血症是一種全身性的炎症反應，而主要發生原因是受到細菌的感染。患有敗血症患者死亡率在全球高達30%到60%，而在最近的一項研究中顯示，慢性阻塞性肺疾病的患者容易感染肺炎，肺炎和敗血症是有密切關聯的，嚴重感染肺炎的患者最終都會導致敗血症的發生，因而肺炎可能是慢性阻塞性肺疾病造成敗血症之間的中介，而肺炎可能是其中一個非常重要關鍵因素之一，因此我們從全民健康保險研究資料庫抓取100 歲以下的新發慢性阻塞性肺疾病病患，再來排除一些會影響我們研究的病患，然後評估慢肺炎及共病是否會影響得到敗血症的風險，最後我們分析出慢性阻塞性肺疾病的患者得到敗血症的風險是比較高的（HR=1.50，95％ CI=1.42-1.59），而在我們控制了肺炎之後，得到敗血症的風險會降低（HR=1.21，95％ CI =1.15-1.28），所以肺炎是導致敗血症的一個非常重要的關鍵因素。然而，較年長的慢性阻塞性肺疾病患者會比年輕的患者有更高的風險得到敗血症，尤其是年齡在60 歲以上的患者。;Chronic obstructive pulmonary disease (COPD) is a major health problem and a leading cause of morbidity and mortality, which is characterized by airflow limitation that is progressive and not fully reversible. Sepsis is a systemic inflammatory response to infection. The fatality rate of patients with sepsis has continues as high as 30%-60% worldwide. In a recent study, COPD are at increased risk of contracting pneumonia, pneumonia and sepsis are interrelated because severe cases of pneumonia can eventually lead to sepsis. Thus pneumonia is acts as an intermediary between COPD and the sepsis, it is an important key factor. Thus, we select ≦100 years newly COPD patients from National Health Insurance Research Database (NHIRD), exclude some patients who affect our study and evaluate the effects of comorbidities or pneumonia with COPD on the sepsis risk. Finally, we analyzed the patients with COPD had an increased risk for sepsis in this cohort (HR=1.50, 95% CI=1.42-1.59), after controlling for pneumonia, the risk was attenuated (HR=1.21, 95% CI =1.15-1.28). Pneumonia was a very strong factor of sepsis. However, the elderly COPD patients were at a higher hazard for sepsis than the younger, especially in the group aged >60 years.
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