硬皮症與貝賽氏症的關聯：一個全國性的世代追蹤研究

The association between systemic sclerosis and Behcet disease: a nationwide cohort study

目的：過去的研究顯示硬皮症和貝賽氏症牽涉相同的細胞激素及致病細胞。本研究的目的在於探討硬皮症是否和貝賽氏症有相關聯。方法：我們利用台灣的全民健康保險研究資料庫和重大傷病檔，找出患有硬皮症的病人及其相應的對照組。每一個硬皮症的病人至多和三個對照組的病人依照性別、年齡、硬皮症第一次的診斷日期作配對。我們依此計算硬皮症病人罹患貝賽氏症的標準化發生率及其95%信賴區間，並利用Cox迴歸分析計算硬皮症病人罹患貝賽氏症的風險比值。結果：從台灣的全民健康保險研究資料庫和重大傷病檔，我們找到2,826位罹患硬皮症的病人以及8,257位對照組病人。硬皮症的病人並沒有較高的貝賽氏症發生率（標準化發生率：1.00，95%信賴區間：0.06至15.86）。在女性病人中，硬皮症的病人也沒有較高的貝賽氏症發生率（標準化發生率：1.75，95%信賴區間：0.16至19.13）。在Cox多變數迴歸分析中，經校正性別和年齡，硬皮症並不影響貝賽氏症發生率（風險比值：0.73，95%信賴區間：0.09至6.26）。只有男性會些微增加貝賽氏症的發生率（風險比值：5.24，95%信賴區間：1.04至6.36）。結論：本篇研究顯示和對照組相比，硬皮症的病人並沒有較高的貝賽氏症發生率。

Objective: Past studies showed systemic sclerosis and Behcet disease shared common cytokines and similar pathogenic cells. The purpose of this study is to investigate whether systemic sclerosis could associate with Behcet disease. Method: From Taiwan’s longitudinal health insurance database 2010 and Registry of Catastrophic Illness, we enrolled patients with systemic sclerosis and controls. Each systemic sclerosis patient was matched to at most three controls by sex, age, month and year of first diagnosis of systemic sclerosis. Standardized incidence ratio (SIR) of Behcet disease in systemic sclerosis patients, and 95% confidence interval (95% CI) were calculated. Cox hazard regression was used to calculate the hazard ratio (HR). Results: 2,826 patients with systemic sclerosis and 8,257 controls were enrolled. Patients with systemic sclerosis didn’t have increased incidence of Behcet disease (SIR: 1.00, 95% CI = 0.06-15.86). In female groups, systemic sclerosis patients also didn’t have increased incidence of Behcet disease (SIR: 1.75, 95% CI = 0.16-19.13). In Cox multivariate regression, systemic sclerosis didn’t have significant effects on the incidence of Behcet disease (HR: 0.73, 95% CI = 0.09-6.26) after adjusting for age and sex. Male gender significantly increased incident Behcet disease (HR: 5.24, 95% CI = 1.04-6.36) after adjusting for age and systemic sclerosis. Conclusion: The results clearly showed that patients with systemic sclerosis didn’t have increased incidence of Behcet disease compared to control subjects.