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研究生:李政源
研究生(外文):Cheng-Yuan Li
論文名稱:接受照光治療的白斑症病人,骨折之風險評估
論文名稱(外文):Risk of fractures in vitiligo patients treated with phototherapy – a retrospective population-based cohort
指導教授:蔡呈芳蔡呈芳引用關係
指導教授(外文):Tsen-Fang Tsai
口試委員:李定達陳祈玲
口試委員(外文):Ding-Dar LeeChi-Ling Chen
口試日期:2015-07-31
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:臨床醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:英文
論文頁數:22
中文關鍵詞:白斑照光治療骨折風險
外文關鍵詞:osteoporosisfracturephototherapyvitiligogenderNational Health Insurance Research Database
相關次數:
  • 被引用被引用:0
  • 點閱點閱:169
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背景: 照光治療可能可以增加骨質密度。然而白斑症病人所接受的照光治療是否能夠降低骨折的風險,截至目前為止仍然是未知的。
目的: 本研究希望能評估照光治療在大於四十歲的白斑症病人上,骨折風險的影響。
方法: 我們使用西元2000年至2010年的台灣全民健保資料庫的資料來進行研究。透過研究找出了共3863名在西元2003年至2009年間新診斷的大於四十歲的白斑症患者。我們進一步將研究的族群分類成三個族群世代來進行研究: 1) 頻繁照光組 – 平均每年至少接受照光治療超過12次; 2) 不頻繁照光組 – 平均每年接受照光治療介於1-12次之間; 3) 未照光組。接受研究的對象一直被追蹤直到發生第一次的髖關節或脊椎骨骨折、從健保資料中退保、或是追蹤終點 ( 西元2010年12月31日止)。資料被進一步使用COX 迴歸模式分析以及按照年齡以及性別分層分析。
結果: 頻繁的照光治療降低了40-64歲白斑症病人的骨折風險 (adjusted hazard ratio=0.18, p=0.009); 然而,進一步的按照性別分層分析顯示頻繁照光之骨折風險防護的效果僅在女性患者中顯現 (adjusted hazard ratio=0.19, p=0.014)。
結論: 本研究提供了第一個證據: 頻繁的照光治療能在中年的白斑症女性患者上,降低骨折的發生風險。

Background: Phototherapy might increase bone mineral density. However, it is unknown whether phototherapy can reduce the risk of fractures in patients with vitiligo.
Objectives: To investigate the effect of phototherapy on fracture risk in vitiligo patients aged 40 or older.
Methods: This population-based cohort study used the 2000–2010 Taiwan National Health Insurance Research Database (NHIRD) to identify 3,863 patients newly diagnosed with vitiligo between 2003 and 2009 at age ≥40 years. Study subjects were classified into three cohorts: 1) frequent phototherapy; 2) infrequent phototherapy; and 3) no phototherapy. Patients were followed until the first hip or vertebral fracture or 31 December 2010. Data were analysed using Cox regression models and also stratified by age and gender.
Results: Frequent phototherapy decreased the fracture risk in patients aged 40–64 years (adjusted hazard ratio=0.18, p=0.009); however, stratification by gender confirmed the fracture prevention effect of frequent phototherapy in female patients only (adjusted hazard ratio=0.19, p=0.014).
Limitations: Some potential confounding variables for fractures were not available in the Taiwan NHIRD.
Conclusions: This study provides the first evidence that frequent phototherapy can reduce the risk of fractures among middle-aged women with vitiligo.

口試委員會審定書………………………………………………………… i
致謝…………………………………………………………………………………… ii
中文摘要………………………………………………………………………… iii
英文摘要…………………………………………………………………………… iv
碩士論文內容
Introduction………………………………………………………………… 1
Materials and methods………………………………………… 3
Results……………………………………………………………………………… 7
Discussion……………………………………………………………………… 9
Acknowledgements……………………………………………………… 14
References……………………………………………………………………… 15
Tables………………………………………………………………………………… 20
Figures……………………………………………………………………………… 22

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