Increased risk of serious pneumococcal disease in patients with asthma
Increased risk of serious pneumococcal disease in patients with asthma
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DOI：
10.1016/j.jaci.2008.07.029
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发表时间：
2008-10-01
影响因子：
14.2
通讯作者：
Jacobson, Robert M.
中科院分区：
文献类型：
--
作者：
Juhn, Young J.;Kita, Hirohito;Jacobson, Robert M.
背景：据报道，哮喘患者患侵袭性肺炎球菌病(IPD)的风险增加。这些发现需要在不同的基于人群的研究环境中得到证实。目的：我们评估了严重肺炎球菌病(SPD)，定义为IPD，肺炎球菌肺炎，或两者都与哮喘状态相关。方法：这是一项回顾性病例对照研究，使用基于标准的方法来确定SPD以及哮喘。受试者是明尼苏达州罗切斯特市的居民，他们在1964年至1983年(主要是肺炎球菌前疫苗时代)患有SPD，他们的年龄和性别匹配的对照组受试者采用1：2匹配。通过使用罗切斯特流行病学项目数据库确定潜在病例和对照对象，并通过病历审查确认。将所有病例和对照纳入1964-1983年间罗彻斯特市所有患有和不患有哮喘的居民的数据库。结果：共查阅3941例潜在的SPD患者的记录，我们确定了174例SPD患者(51%为男性，94%为白人)。SPD与所有年龄段的哮喘史(优势比，2.4；95%CI，0.96.6；P=.09)和成年人(优势比，6.7；95%CI，1.627.3；P=.01)相关，控制了IPD和吸烟暴露的高危条件。成人人群的人群归因风险百分比为17%。结论：成人哮喘患者患SPD的风险可能增加。
Background: Individuals with asthma have been reported to be at increased risk of invasive pneumococcal disease (IPD). These findings need to be confirmed in a different population-based study setting.Objective: We assessed whether serious pneumococcal disease (SPD), defined as an IPD, pneumococcal pneumonia, or both, was associated with asthma status.Methods: This is a retrospective case-control study using criteria-based methods for ascertaining SPD, as well as asthma. Subjects were residents of Rochester, Minnesota, who had SPD between 1964 and 1983 (the primarily pre-pneumococcal vaccine era) and their age-and sex-matched control subjects using 1:2 matching. Potential cases and control subjects were identified by using the Rochester Epidemiology project database and confirmed by medical record reviews. All cases and control subjects were merged with the database comprising the entire pool of Rochester residents with and without asthma between 1964 and 1983.Results: A total of 3941 records of potential patients with SPD were reviewed, and we identified 174 cases of SPD (51% male subjects and 94% white subjects). SPD was associated with a history of asthma among all ages (odds ratio, 2.4; 95% CI, 0.96.6; P = .09) and among adults (odds ratio, 6.7; 95% CI, 1.627.3; P = .01), controlling for high-risk conditions for IPD and smoking exposure. The population-attributable risk percentage was 17% in the adult population.Conclusion: Adults with asthma might be at increased risk of SPD.