Geographical Clustering of Amyotrophic Lateral Sclerosis in South-East England: A Population Study
Geographical Clustering of Amyotrophic Lateral Sclerosis in South-East England: A Population Study
复制标题
英格兰东南部肌萎缩侧索硬化症的地理聚集：一项人口研究
作者：
K. Scott;K. Abhinav;B. Stanton;C. Johnston;M. Turner;Mary‐Ann Ampong;M. Sakel;R. Orrell;R. Howard;C. Shaw;P. Leigh;A. Al
背景资料：肌萎缩侧索硬化症（ALS）是一种运动神经元退行性疾病，可导致进行性瘫痪，最终因呼吸衰竭而死亡。引发ALS的环境因素可能导致病例的地理聚集模式。我们使用英格兰东南部ALS人口登记册来检验这一假设，该登记册覆盖了东南部伦敦、肯特和邻近县的部分地区。方法：将登记簿的服务范围划分为邮政编码区和邮政编码区。使用标准化残差法和SaTScan程序将ALS的预期发生率（根据年龄和性别调整）与观察到的发生率进行比较。结果：有406例ALS确定在集水区在研究期间。在126个邮政编码区中，有4个区（均位于大伦敦）与平均值的残差>2.5个SD。同样，有15个邮政编码区（共420个）的残差与平均值的SD>1.96。其中9个在大伦敦。SaTScan确定了一个半径为5.61公里的区域，其中ALS的相对风险为1.70（p = 0.012）。该地区与邮政编码区和使用残差方法确定的一些部门重叠。结论：这些研究结果表明，在英格兰东南部的一些邮政编码区的ALS病例过多。
Background: Amyotrophic lateral sclerosis (ALS) is a degenerative disease of motor neurons that causes progressive paralysis and eventually results in death from respiratory failure. Environmental factors that trigger ALS might result in a pattern of geographical clustering of cases. We tested this hypothesis using the South-East England ALS population register, which covers south-east London, Kent and parts of neighbouring counties. Methods: The register’s catchment area was divided into postcode districts and sectors. The expected rates of ALS (adjusted for age and sex) were compared with the observed rates using a standardised residuals method and the SaTScan programme. Results: There were 406 cases of ALS identified in the catchment area during the study period. Four of the 126 postcode districts, all in Greater London, had residuals >2.5 SDs from the mean. Similarly, there were 15 postcode sectors (out of 420) that had residuals >1.96 SDs from the mean. Nine of these were in Greater London. SaTScan identified an area that had a 5.61-km radius in which the relative risk of ALS was 1.70 (p = 0.012). This area overlapped with the postcode districts and some of the sectors identified using the residuals method. Conclusions: These findings suggest an excess of ALS cases in some postcode districts in south-east England.