探討我國全身性紅斑性狼瘡患者性別比及好發年齡層分析

To Investigate the Age at Onset and Gender Distribution of Patients with Systemic Lupus Erythematosus in Taiwan

全身性紅斑性狼瘡（Systemic Lupus Erythematosus, SLE）一般在文獻上常常僅提到好發生於15到40歲之間且以女性居多。是一種慢性炎症性結締組織疾病，且女性與男性患者性別比為9：1，男性發病率雖然較女性低，若一旦發病則可能較為嚴重等等。但文獻中未充分提及女性與男性患者在各發病年齡層的差異性，且育齡婦女正值年輕歲月所組成的新家庭，每當其發生後對其一生影響頗巨，然而雖然SLE是屬於健保的重大傷病範圍，但個案間彼此病況差異頗大，故SLE是非常值得探討的議題。本研究以全民健康保險保險人資訊整合應用服務中心的健保資料庫回溯性研究，依據1995～2015年（共21年）重大傷病檔（801）先依身分證字號及登錄日期遞升排序再重組歸人後選擇初次診斷為SLE患者國際疾病分類代碼（ICD-9-CM=710.0）進行男女性別好發年齡層分析。年齡層分類參考World Health Organization（WHO）年齡層劃分及國內婦女停經年齡作為分類標準，研究結果顯示國內迄至2015年底共有27,736位SLE患者，在男女性別的好發年齡層，確實有差異性（X2 =467, p< 0.001），整體男女性別比為1：7.3。但在12歲以下青春期前的年齡層男女性別比為1：5.6、13至50歲的年齡層男女性別比達到1：8.8、51至65歲的年齡層男女性別比逐漸恢復至1：5.7、而66至79歲的年齡層男女性別比降至1：2.8。故本研究顯示婦女停經後可能相對會降低罹患全身性紅斑性狼瘡的風險。

Systemic Lupus Erythematosus (SLE) generally just mentions in the literature that it occurs between 15 and 40 years old and is mostly female. It is a chronic inflammatory of connective tissue disease, and the gender ratio of female-to-male patients is 9: 1. Although the incidence rate of males is lower than females, it may be more serious once it occurs. However, the literature does not fully mention the differences between female and male patients at each age-rank of onset, and women of childbearing era are within a new-family. Every time they occur, they have a great impact on their life. However, although SLE is belongs to catastrophic disease in health insuranceand it's quite different from case to case, so SLE is a worth discussing or sharing feature with each other. This is retrospective study of the health insurance database of the Health Research Data Integration Service from National Health Insurance Administration, based on 1995-2015 (21 years in total) catastrophic files, sorted in ascending by ID number and registration date, and then restructure the files by ID. After that, the ICD-9-CM = 710.0 for the first diagnosis of SLE was selected for male and female distribution. The age classification refers to the World Health Organization (WHO) age classification and the menopausal age of women as the classification criteria. The results of the study show that there are 27,736 SLE patients accumulated in the year of 2015. There are indeed differences in the prevalence of male and female age-rank groups ( X2 = 467, p<0.001), the overall male-to-female gender ratio is 1: 7.3. However, the gender ratio of men-and-women under the age of 12 is 1: 5.6, the gender ratio of 13 to 50 years reaches 1: 8.8, and the gender ratio of 51 to 65 years old gradually returns to 1: 5.7, The gender ratio of 66-79 years olds' men-and-women fell to 1: 2.8. Therefore, this study shows that women may relatively reduce the risk of systemic lupus erythematosus after menopause.