修格蘭綜合症與中風之間的關係：台灣全國性人口研究

Association between Sjögren's syndrome and stroke: A nationwide population-based study in Taiwan

目的：修格蘭綜合症是常見的發炎症性風濕性疾病之一。雖然許多風濕性疾病與中風有關，但修格蘭綜合症中的證據尚未完全闡明。方法：該研究調查了修格蘭綜合症是否增加了缺血性或出血性中風的風險。收集了哈元2000年至2005年新診斷修格蘭綜合症患者，且這5079名患者在診斷修格蘭綜合症之前並沒有中風的紀錄。與對照組（非修格蘭綜合症患者）相比，估計其發病率和風險比值（HR）。結果：在5079名修格蘭綜合症患者和25395名對照組（非修格蘭綜合症患者）中，有1350名受試者發生缺血性中風，850名受試者發生出血性中風。修格蘭綜合症患和對照組發生缺血性中風的發生率分別為5.96／1,000和6.29／1,000人年。修格蘭綜合症患者對照組出血性中風發生率分別為4.14／1,000和3.71／1,000人年。修格蘭綜合症患者的缺血性中風和出血性中風與年齡和性別調整的風險比值（HR）（95%CI）分別為0.92（0.79－1.07）和1.10（0.92－1.31）。另外調整合併症和藥物後，修格蘭綜合症患者的缺血性中風和出血性中風的風險比值（HR）（95%CI）為0.70（0.57－0.86）和1.05（0.84－1.31）。結論：修格蘭綜合症與缺血性中風或出血性中風的風險增加無關。

Background: Sjögren’s syndrome (SS) is one of the more common inflammatory rheumatic diseases. While many rheumatic diseases are linked to stroke, the evidence in SS has not been fully elucidated. Methods: This study investigated whether SS increased the risk of ischemic or hemorrhagic stroke in a large, nationwide cohort. Data for 5079 patients who were newly diagnosed with SS from 2000 to 2005 and who did not have a stroke prior to diagnosis of SS were obtained from the Registry of Catastrophic Illness in Taiwan. Incidence and hazard ratios (HR) were estimated compared with matched normal controls. Results: Among 5079 SS patients and 25395 controls (non-SS patients), 1350 subjects (205 SS patients and 1145 controls) developed ischemic stroke and 850 subjects (150 SS patients and 700 controls) developed hemorrhagic stroke. The incidences of ischemic stroke occurrence of patients with SS and controls are 5.96/1,000 and 6.29/1,000 person years. And the incidences of hemorrhagic stroke occurrence of patients with SS and controls are 4.14/1,000 and 3.71/1,000 person years. Ischemic stroke and hemorrhagic stroke in SS patients were associated with age and sex adjusted HR (95% CI) of 0.92(0.79- 1.07) and 1.10(0.92-1.31), respectively. After additionally adjusting for comorbidities and medications at diagnosis, Ischemic stroke and hemorrhagic stroke in SS patients were associated with a multivariable HR (95% CI) of 0.70 (0.57-0.86) and 1.05 (0.84-1.31). Conclusions: SS is not associated with an increased risk of ischemic stroke or hemorrhagic stroke.