Epidemiology and natural history of primary biliary cirrhosis in a US community
Epidemiology and natural history of primary biliary cirrhosis in a US community
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DOI：
10.1053/gast.2000.20197
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发表时间：
2000-12-01
期刊：
影响因子：
29.4
通讯作者：
Dickson, ER
中科院分区：
文献类型：
--
作者：
Kim, WR;Lindor, KD;Dickson, ER
背景与目的：原发性胆汁性肝硬化（PBC）的流行病学在美国还没有系统的研究。我们报告的发病率和患病率，这种情况在一般人群。我们还研究了马约自然病程模型在社区PBC患者中的有效性。研究方法：罗切斯特流行病学项目需要一个计算机化的诊断索引，从卫生保健接触的居民奥姆斯特德县，明尼苏达州。对于使用该数据库识别的潜在病例，审查了完整的（住院和门诊）病历，以验证诊断并提取应用马约模型所需的信息。我们估计了该人群中PBC的发病率和患病率，并将社区中PBC患者的实际生存率与马约自然史模型预测的PBC患者生存率进行了比较。结果如下：1975-1995年，年龄校正（至1990年美国白人）PBC发病率为每10万人-年，女性为4.5（95%置信区间[CI]，3.1-5.9），男性为0.7（95% CI，0.1-1.3），总体为2.7（95% CI，1.9-3.5）。截至1995年，经年龄和性别调整的每10万人患病率为：女性65.4（95% CI，43.0-87.9），男性12.1（95% CI，1.1-23.1），总体40.2（95% CI，27.2-53.1）。马约自然史模型准确地预测了这些患者的实际生存期。结论：这是美国首次描述PBC的流行病学，表明PBC在美国的发病率和流行率是最高的。这些来自社区人群的PBC患者的结果进一步验证了马约PBC的自然病程模型。
Background & Aims: The epidemiology of primary biliary cirrhosis (PBC) has not been studied systematically in the United States. We report the incidence and prevalence of this condition in the general population. We also examined the validity of the Mayo natural history model for PBC among these unselected patients from the community. Methods: The Rochester Epidemiology Project entails a computerized index of diagnoses from the health care encounters of residents of Olmsted County, Minnesota. For potential cases identified using this database, the complete (inpatient and outpatient) medical records were reviewed to verify the diagnosis and extract information necessary for the application of the Mayo model. We estimated the incidence and prevalence of PBC in this population and compared the actual survival of patients with PBC in the community with the survival predicted for PBC patients by the Mayo natural history model. Results: The age-adjusted (to 1990 U.S. whites) incidence of PBC per 100,000 person-years for years 1975-1995 was 4.5 (95% confidence interval [CI], 3.1-5.9) for women, 0.7 (95% CI, 0.1-1.3) for men, and 2.7 (95% CI, 1.9-3.5) overall. The age- and sex-adjusted prevalence per 100,000 persons as of 1995 was 65.4 (95% CI, 43.0-87.9) for women, 12.1 (95% CI, 1.1-23.1) for men, and 40.2 (95% CI, 27.2-53.1) overall. The Mayo natural history model accurately predicted the actual survival of these patients. Conclusions: This first description of the epidemiology of PBC in the United States indicates that its incidence and prevalence in this country ave among the highest reported. Outcomes among these unselected patients from a community population further validated the Mayo natural history model of PBC.