2006年至2015年台灣僵直性脊椎炎流行病學趨勢：全國人口十年研究

Trend of Epidemiology of Ankylosing Spondylitis between 2006 and 2015 in Taiwan: A 10 years Nationwide Population Study

Objective: There are few nationwide estimates for prevalence, incidence and mortality of AnkylosingSpondylitis (AS) in Taiwan. The aim of this study was to determine trends in the prevalence, incidence andmortality of AS between 2006 and 2015 in Taiwan.Methods: The National Health Insurance Database was used to identify AS patients and to estimate theprevalence, incidence and mortality of AS for each calendar year between January 1, 2006, and December31, 2015. AS was defined as that the patient who has two or more records of rheumatologist diagnosis.Age- and sex-standardization was used to ensure comparability of prevalence, incidence and mortalitywithin study period, and the population structure in year 2015 was the reference.Results: AS prevalence is 96.9 (95% CI, 95.7 to 98.1 per 100,000 people), and incidence is 24.2 (95%CI, 23.6 to 24.8 per 100,000 person-years) in 2015. Male had a higher prevalence (116.4 versus 78.0 per100,000 people) and incidence (27.7 versus 20.8 per 100,000 person-years) of AS than female in 2015.The prevalence and incidence of AS in male was low in individuals younger than 19 years of age, peakedrapidly in the ages 20 to 29 years and decreased gradually. Male has slightly lower 5-years survival ratethan female.Conclusions: AS is a common rheumatic disease in Taiwan. Based on our study, we revealed that malehas earlier onset of age, higher prevalence and incidence, and slightly lower 5-years survival rate thanthose in female. 目的：僵直性脊椎炎（Ankylosing spondylitis, AS）是一種慢性發炎性風濕性疾病，目前在台灣地區少有全國性盛行率、發生率與死亡率的估計。本研究的目的是確定2006年至2015年間台灣一般人群中，僵直性脊椎炎盛行率和發病率的趨勢。方法：使用國家健康保險資料庫用於識別僵直性脊椎炎患者，估計自2006年1月1日至2015年12月31日，每一日曆年裡僵直性脊椎炎的盛行率、發生率與死亡率。僵直性脊椎炎患者被定義為：曾有兩次或兩次以上的風濕科醫師診斷記錄。並使用年齡和性別標準化，來確保研究期間盛行率、發生率與死亡率的可比性，並以2015年的人口結構做為參考值。結果：在2015年，僵直性脊椎炎的整體盛行率為每10萬人中有96.9例（95%CI，95.7－98.1），僵直性脊椎炎的整體發生率為10萬人－年中24.2（95%CI，23.6－24.8）。男性患者比女性患者有較高的盛行率（每10萬人中，在男性有116.4例，在女性有78.0例），與較高的發生率（每10萬人－年中，在男性為27.7，在女性為20.8）。男性僵直性脊椎炎患者，在年齡在19歲以下的盛行率和發生率較低，在20至29歲之間迅速上升，之後逐漸下降。男性僵直性脊椎炎患者的5年存活率略低於女性患者。結論：根據我們的研究，我們發現僵直性脊椎炎是台灣常見的風濕病，其中以男性僵直性脊椎炎患者的發病年齡較早、患病的盛行率與發生率高於女性患者，以及五年存活率略低於女性患者。