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標題: | 第二型糖尿病女性患者的嚴重排尿障礙發生率較高:根據全國人口所進行的世代研究 Women with type 2 diabetes are associated with higher incidence of significant voiding dysfunction: A nationwide population-based cohort study |
作者: | Ming-Chih Lai 賴明志 |
指導教授: | 余宏政(Hong-Jeng Yu) |
關鍵字: | 糖尿病,排尿障礙,發生率,女性,台灣, diabetes mellitus,voiding dysfunction,incidence,women,Taiwan, |
出版年 : | 2019 |
學位: | 碩士 |
摘要: | 目標
本研究是在13年的期間內,評估第二型糖尿病女性患者的嚴重排尿障礙(VD)的發生率和風險。 研究材料和方法 這份世代群組研究使用了台灣全民健保研究資料庫(National Health Insurance Research Database, NHIRD)的資料,從2001年到2013年中,找出新診斷的第二型糖尿病患者(DM世代群組),以及符合年齡、共病現象和Charlson共病指標(CCI)分數的患者(非DM世代群組)。嚴重VD的定義為膀胱排尿有困難,需要bethanechol或tamsulosin的治療。對於嚴重VD的發生率,我們調查到2013年底為止。據此計算出嚴重VD的發生率(每年每一萬人),並使用Cox比例風險迴歸模型(Cox proportional hazards regression model)估算風險比例。使用Kaplan-Meier法(Kaplan-Meier),在兩個世代群組中,繪製出嚴重VD的累積發生率圖形。 結果 在13年期間,第二型糖尿病女性患者的嚴重VD發生率為1.42%。DM世代群組和非DM世代群組共納入34,125位病患。嚴重VD發生率在DM世代群組和非DM世代群組中,分別約為有20.0位和11.4位(每年每一萬人)。針對混擾因子進行修正後,可以推算出,第二型糖尿病女性患者的嚴重VD發生率風險增加1.79倍。在10年的後續追蹤期間,DM世代群組的嚴重VD累積發生率顯著較高(2.01% vs. 1.07%, p<0.0001)。 結論 對於女性,第二型糖尿病和嚴重VD的風險上升有關聯性。因此,臨床醫師應該教育女性病患,使其了解第二型糖尿病和嚴重VD之間的關聯性。 Objective: To evaluate the incidence and risk of significant voiding dysfunction (VD) in women with type 2 diabetes during a 13-year study period. Materials and methods: This cohort study utilized data from the National Health Insurance Research Database (NHIRD) of Taiwan to identify patients with type 2 diabetes (DM cohort) and age-, comorbidity-, and Charlson comorbidity index (CCI) score-matched cohort (non-DM cohort) from 2001 to 2013. Significant VD was defined as difficulty in bladder emptying requiring bethanechol or tamsulosin treatment. Significant VD occurrence was monitored until the end of 2013. Incidence rate of significant VD (per 10,000 person-years) was calculated, and hazards ratios were estimated using Cox proportional hazards regression models. Cumulative incidence of significant VD in both cohorts were plotted using the Kaplan-Meier method. Results Incidence of significant VD in women with type 2 diabetes is 1.42% during a 13-year period. A total of 34,125 patients were selected for the DM and non-DM cohorts, respectively. Incidence rates of significant VD were approximately 20.0 and 11.4 per 10,000 person-years for the DM and non-DM cohorts, respectively. After adjusting for potential confounders, a 1.79-fold increased risk of significant VD was observed in women with type 2 diabetes. Cumulative incidence of significant VD was significantly higher in the DM cohort at the 10-year follow-up (2.01% vs. 1.07%, p<0.0001). Conclusion Type 2 diabetes is independently associated with increased significant VD risk in women. Therefore, clinicians should be aware of and educate female patients about the association between type 2 diabetes and significant VD. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/78635 |
DOI: | 10.6342/NTU201902670 |
全文授權: | 有償授權 |
顯示於系所單位: | 臨床醫學研究所 |
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