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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/77575完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 方啟泰 | zh_TW |
| dc.contributor.author | 吳睿寧 | zh_TW |
| dc.contributor.author | Jui-Ning Wu | en |
| dc.date.accessioned | 2021-07-10T22:09:36Z | - |
| dc.date.available | 2024-02-28 | - |
| dc.date.copyright | 2018-10-11 | - |
| dc.date.issued | 2018 | - |
| dc.date.submitted | 2002-01-01 | - |
| dc.identifier.citation | 1. Kuo, M.-C., et al., Type 2 diabetes: an independent risk factor for tuberculosis: a nationwide population-based study. PLoS One, 2013. 8(11): p. e78924.
2. Stead, W.W., et al., Tuberculosis as an endemic and nosocomial infection among the elderly in nursing homes. New England Journal of Medicine, 1985. 312(23): p. 1483-1487. 3. Pealing, L., et al., Risk of tuberculosis in patients with diabetes: population based cohort study using the UK Clinical Practice Research Datalink. BMC Medicine, 2015. 13(1): p. 135. 4. Lee, P., et al., Tuberculosis and diabetes in low and moderate tuberculosis incidence countries. The International Journal of Tuberculosis and Lung Disease, 2018. 22(1): p. 7-16. 5. Lin, Y.-T., et al., Cirrhosis as a risk factor for tuberculosis infection—a nationwide longitudinal study in Taiwan. American Journal of Epidemiology, 2014. 180(1): p. 103-110. 6. Lim, C.-H., et al., One-Year Tuberculosis Risk in Rheumatoid Arthritis Patients Starting Their First Tumor Necrosis Factor Inhibitor Therapy from 2008 to 2012 in Taiwan: A Nationwide Population-Based Cohort Study. PLoS One, 2016. 11(11): p. e0166339. 7. Sharma, S., A. Mohan, and T. Kadhiravan, HIV-TB co-infection: epidemiology, diagnosis & management. Indian J Med Res, 2005. 121(4): p. 550-567. 8. Getahun, H., et al., HIV infection—associated tuberculosis: the epidemiology and the response. Clinical Infectious Diseases, 2010. 50(Supplement_3): p. S201-S207. 9. Whalen, C., et al., Accelerated course of human immunodeficiency virus infection after tuberculosis. American journal of Respiratory and Critical Care Medicine, 1995. 151(1): p. 129-135. 10. Trinh, Q., et al., Tuberculosis and HIV co-infection—focus on the Asia-Pacific region. International Journal of Infectious Diseases, 2015. 32: p. 170-178. 11. Jeon, C.Y. and M.B. Murray, Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS medicine, 2008. 5(7): p. e152. 12. Lee, P.-H., et al., Diabetes and risk of tuberculosis relapse: nationwide nested case-control study. PLoS One, 2014. 9(3): p. e92623. 13. Lee, P.-H., et al., Glycemic control and the risk of tuberculosis: a cohort study. PLoS medicine, 2016. 13(8): p. e1002072. 14. Gómez‐Reino, J.J., et al., Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active‐surveillance report. Arthritis & Rheumatology, 2003. 48(8): p. 2122-2127. 15. Wallis, R., et al., Granulomatous infectious diseases associated with tumor necrosis factor antagonists. Clinical Infectious Diseases, 2004. 38(9): p. 1261-1265. 16. Lim, C.H., et al., The risk of tuberculosis disease in rheumatoid arthritis patients on biologics and targeted therapy: A 15-year real world experience in Taiwan. PLoS One, 2017. 12(6): p. e0178035. 17. Fang, W.-L., et al., Incidence of and risk factors for tuberculosis (TB) in gastric cancer patients in an area endemic for TB: A nationwide population-based matched cohort study. Medicine, 2015. 94(47). 18. Cheng, M.P., et al., Risk of active tuberculosis in patients with cancer: a systematic review and metaanalysis. Clinical Infectious Diseases, 2016. 64(5): p. 635-644. 19. Chou, K.-J., et al., Tuberculosis in maintenance dialysis patients. Nephron, 2001. 88(2): p. 138-143. 20. Moore, D.A., et al., High rates of tuberculosis in end-stage renal failure: the impact of international migration. Emerging infectious diseases, 2002. 8(1): p. 77. 21. Al-Efraij, K., et al., Risk of active tuberculosis in chronic kidney disease: a systematic review and meta-analysis. The International journal of tuberculosis and lung disease, 2015. 19(12): p. 1493-1499. 22. Gómez‐Reino, J.J., et al., Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active‐surveillance report. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 2003. 48(8): p. 2122-2127. 23. Ai, J.-W., et al., The risk of tuberculosis in patients with rheumatoid arthritis treated with tumor necrosis factor-α antagonist: a metaanalysis of both randomized controlled trials and registry/cohort studies. The Journal of rheumatology, 2015: p. jrheum. 150057. | - |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/77575 | - |
| dc.description.abstract | 背景:
根據台灣衛生福利部的資料顯示，2014 年台灣結核病 (TB) 發生率約為每十萬人有48.4個人，跟世界衛生組織 (WHO) 提供的資料相比，台灣發生率為美國的15倍、英國的4倍、日本的2.5倍，這顯示台灣結核病的發生率較已開發國家高出許多。而目前關於慢病跟結核病的研究大多屬於百萬人抽樣檔，且部分只考慮單一慢病與結核病的關係，忽略研究對象可能有多種慢病同時影響結核病發生率，同時台灣目前尚未針對長照機構對於結核病發生率的影響做研究。因此，本篇以極具參考性的資料，使用2012 年全台灣2300萬人口進行研究，同時分析長照機構、慢病以及重大傷病，對於各年齡層結核病發生率 (Incidence Rate) 的影響。 方法: 本篇使用2012-2015年全人口健保資料庫，採用世代研究追蹤2012年之人，有第二型糖尿病、長照以及各重大傷病之人在未來兩年內之結核病發生率。 研究結果: 經過多變項校正後，女性結核病風險一律比男性低，為男性的0.4倍(adjusted incidence rate ratio,0.403;95% CI :0.39-0.41)，以小於50 歲無慢病與無入住長照機構的男性為基準組，50 歲男性若有慢病，每個慢病大約會增加2-5 倍左右的TB風險，而年輕女性則是介於1-3 倍之間。隨著年齡增長，慢病造成的TB風險一致攀升，大於80歲是結核病風險最高的年齡層。其中較高的風險落在長照機構、以及自體免疫疾病，以七十到八十歲的男性年長者為例，進入長照機構者，會比基準組的男性多了25.6 倍的結核病風險，而自體免疫疾病則平均增加高達32倍左右的結核病風險。再者，慢性腎衰竭以及惡性腫瘤也會增加25倍和17倍風險。 使用族群暴露歸因百分比 (Population Attributable Fraction ,PAF)，發現全人口中有8.8%的結核病發病可歸因於糖尿病此一暴露，為本研究討論的慢病中最高的疾病，PAF 次高的暴露為癌症，有大約6%得TB 的人口可歸因於癌症的暴露。 結論: 年老以及自體免疫疾病和長照機構是大為增加結核病發生率的危險因子。而使用族群暴露歸因百分比 (PAF) 來看，會發現第二型糖尿病占最高的百分比，癌症次之(糖尿病PAF:8.8%、癌症PAF:6%) | zh_TW |
| dc.description.provenance | Made available in DSpace on 2021-07-10T22:09:36Z (GMT). No. of bitstreams: 1 ntu-107-R05849030-1.pdf: 1441255 bytes, checksum: 23044840e35501fcd12613ad337b0605 (MD5) Previous issue date: 2018 | en |
| dc.description.tableofcontents | 第一章前言 .................................................................................................................... 1
第二章 文獻探討 ............................................................................................................ 3 2.1 結核病之共病症................................................................................................... 3 2.2 結核病危險因子之探討....................................................................................... 3 2.2.1 第二型糖尿病................................................................................................. 3 2.2.2 類風濕性關節炎............................................................................................. 3 2.2.3 惡性腫瘤......................................................................................................... 4 2.2.4 腎衰竭............................................................................................................. 4 2.2.5 肝硬化疾病..................................................................................................... 4 第三章 材料與方法........................................................................................................ 5 3.1 研究設計............................................................................................................... 5 3.2 結核病的定義....................................................................................................... 5 3.3 第二型糖尿病與長照機構的定義....................................................................... 5 3.4 重大傷病的定義................................................................................................... 6 3.5 統計分析............................................................................................................... 6 第四章 結果 .................................................................................................................... 8 4.1 單變項分析........................................................................................................... 8 4.1.1 第二型糖尿病與結核病的關係..................................................................... 8 4.1.2 長照與結核病的關係..................................................................................... 8 4.1.3 肝硬化與結核病的關係................................................................................. 9 4.1.4 惡性腫瘤與結核病的關係............................................................................. 9 4.1.5 類風濕性關節炎之自體免疫疾病與結核病的關係..................................... 9 4.1.6 非類風濕性關節炎之自體免疫疾病與結核病的關係............................... 10 4.1.7 慢性腎衰竭與結核病的關係....................................................................... 10 4.1.8 HIV 與結核病的關係................................................................................. 10 4.2 多變項分析......................................................................................................... 11 4.2.1 多變項之參數估計值................................................................................... 11 4.2.2 年齡層與各個慢病的發生率比值............................................................... 11 4.2.3 族群可歸因暴露(Population Attributable Fraction, PAF) ......................... 12 第五章 結論與研究限制 .............................................................................................. 13 5.1 結論..................................................................................................................... 13 5.2 研究優勢與限制................................................................................................. 15 致謝 ................................................................................................................................ 16 參考文獻 ........................................................................................................................ 17 | - |
| dc.language.iso | zh_TW | - |
| dc.title | 共病對不同年齡層民眾結核病發生率的影響:台灣健保資料庫全人口檔分析 | zh_TW |
| dc.title | Non-communicable diseases and risk of tuberculosis: an age-stratified whole population-based study in Taiwan | en |
| dc.type | Thesis | - |
| dc.date.schoolyear | 106-2 | - |
| dc.description.degree | 碩士 | - |
| dc.contributor.oralexamcommittee | 林先和;施惟量 | zh_TW |
| dc.contributor.oralexamcommittee | ;; | en |
| dc.subject.keyword | 結核病,長期照護機構,重大傷病,慢性非傳染性疾病, | zh_TW |
| dc.subject.keyword | Tuberculosis,Long-term care institution,Major illness,Noncommunicable diseases, | en |
| dc.relation.page | 44 | - |
| dc.identifier.doi | 10.6342/NTU201802360 | - |
| dc.rights.note | 未授權 | - |
| dc.date.accepted | 2018-08-03 | - |
| dc.contributor.author-college | 公共衛生學院 | - |
| dc.contributor.author-dept | 流行病學與預防醫學研究所 | - |
| 顯示於系所單位： | 流行病學與預防醫學研究所 | |
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