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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Serious infections in patients with myasthenia gravis: population‐based cohort study
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Serious infections in patients with myasthenia gravis: population‐based cohort study

机译：Myasthenia患者的严重感染肌炎肌肉：基于人口的队列研究

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Background and purpose To characterize the frequency and risk of serious infections in patients with myasthenia gravis (MG) relative to age/sex/area‐matched comparators. Methods This was a population‐based cohort study in Ontario, Canada of patients with newly‐diagnosed MG and 1:4 age/sex/area‐matched general population comparators accrued from 1 April 2002 to 31 December 2015. The main outcome was a serious infection, defined by a primary diagnosis code on a hospitalization or emergency department record. We computed crude overall and sex‐specific rates of infection among patients with MG and comparators, and the frequency of specific types of infection. Adjusted hazard ratios and 95% confidence intervals were estimated using Cox regression. Results Among 3823 patients with MG, 1275 (33.4%) experienced a serious infection compared with 2973/15?292 (19.4%) of comparators over a mean follow‐up of over 5?years. Crude infection rates among patients with MG were twice those in comparators (72.5 vs. 35.0 per 1000 person‐years, respectively). The most common infection types were respiratory infections, particularly bacterial pneumonia. After adjustment for potential confounders, MG was associated with a 39% increased infection risk (adjusted hazard ratio, 1.39; 95% confidence intervals, 1.28–1.51). Conclusions Patients with MG are at a significantly higher absolute and relative risk of serious infections compared with age/sex/area‐matched comparators. This needs to be considered when selecting MG treatments and when planning vaccination/prophylaxis. Determining whether this risk is due to the use of immunosuppressive medications (vs. MG itself) is an important area for future research.
机译：背景和目的在于年龄/性别/地区匹配的比较器表征肌肌肌炎重子（MG）患者严重感染的频率和风险。方法是，这是一项基于人口的队列群体，在新诊断的MG和1：4年龄/性/地区匹配的一般人口比较患者中，从2002年4月1日至2015年12月31日累积了1：4年龄/性别/地区匹配的一般人口比较。主要结果是严重的感染，由住院或急诊部门记录的主要诊断码定义。我们在MG和比较器患者中计算了粗糙的整体和性别感染率，以及特定类型感染的频率。使用COX回归估计调整后的危险比和95％置信区间。结果3823例MG患者，1275名（33.4％），与2973/15岁（19.4％）的比较器相比，比较器的平均随访超过5岁，经历了严重的感染。 MG患者中的粗药物感染率是比较器中的两倍（分别为每1000人/每年35.0岁）。最常见的感染类型是呼吸道感染，特别是细菌肺炎。在调整潜在混凝剂后，MG与39％的感染风险增加（调整危险比，1.39; 95％置信区间，1.28-1.51）相关。结论与年龄/性/地区匹配的比较器相比，MG的患者的绝对和相对的感染风险显着高。在选择Mg治疗时以及计划疫苗接种/预防时，需要考虑这一切。确定这种风险是否是由于使用免疫抑制药物（Vs. mg本身）是未来研究的重要领域。

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