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AR:社会经济地位低的人群中SLE和LN患病率高

2013-4-15 作者:AR   来源:dxy 我要评论0
Tags: SLE  LN  患病率  


社会经济地位低越低,SLE和LN的患病率越高

系统性红斑狼疮(SLE)和狼疮肾炎(LN)严重影响了少数民族患者和社会经济地位较低(SES)的患者。针对这一情况,来自美国马萨诸波士顿塞布里格姆和妇女医院的Candace H. Feldman等人进行了一项研究,该研究的目的是调查美国接受医疗补助的低收入人口中SLE和LN的流行病学和社会人口统计情况。研究结果在线发布在2013年3月的《关节炎与风湿病》(ARTHRITIS & RHEUMATISM)杂志上,作者发现,全国性医疗补助人口范围中,SLE和LN的患病率和发生率存在人口统计学差异。了解这些低收入人群中SLE患者及其并发症的负担的加重,对合理资源分配和专项护理有重要指导意义。
医疗补助制度分析的精华数据库资源来自于47个州和哥伦毕亚特区华盛顿的计费索赔。研究者来利用该数据库,分析了2000至2004年参与了医疗补助3个月以上的年龄在18-65岁的23.9亿人口。受试者均明确诊断为SLE(≥3次访视>30天,第九次修订的国际疾病分类诊断标准[ICD-9]编码为710)或者明确诊断为LN(≥2次访视,出现明确诊断的肾小球肾炎、蛋白尿或肾衰竭)。研究者使用了来自美国人口变量普查的有效综合数据,分析了美国和SES人群的SLE和LN的患病率和发病率、社会人口类别分层及美国风湿病学会(ACR)成员中风湿病专科医生人数。
研究结果如下,该研究共发现34,339位明确诊断的SLE患者(患病率: 143.7/100,000患者年)和7,388位(21.5%)明确诊断的LN患者(患病率:30.9/100,000患者年)。女性SLE的患病率比男性高6倍,非洲裔美国人SLE的患病率比白人几乎高两倍,美国南部的SLE患病率最高。少数民族的LN患病率比白人更高。最低SES的区域患病率最高,ACR风湿病学家人数最少的区域的患病率最低。SLE的发病率是23.2/100.000患者年,LN的发病率是6.9/100,000患者年,社会人口统计学趋势相似。
研究发现,全国性医疗补助人口范围中,SLE和LN的患病率和发生率存在人口统计学差异。了解这些低收入人群中SLE患者及其并发症的负担的加重,对合理资源分配和专项护理有重要指导意义。
系统性红斑狼疮相关的拓展阅读:


Epidemiology and sociodemographics of systemic lupus erythematosus and lupus nephritis among US adults with Medicaid coverage, 2000-2004.
OBJECTIVE
Systemic lupus erythematosus (SLE) and lupus nephritis (LN) disproportionately affect individuals who are members of racial/ethnic minority groups and individuals of lower socioeconomic status (SES). This study was undertaken to investigate the epidemiology and sociodemographics of SLE and LN in the low-income US Medicaid population.
METHODS
We utilized Medicaid Analytic eXtract data, with billing claims from 47 states and Washington, DC, for 23.9 million individuals ages 18-65 years who were enrolled in Medicaid for >3 months in 2000-2004. Individuals with SLE (≥3 visits >30 days apart with an International Classification of Diseases, Ninth Revision [ICD-9] code of 710.0) and with LN (≥2 visits with an ICD-9 code for glomerulonephritis, proteinuria, or renal failure) were identified. We calculated SLE and LN prevalence and incidence, stratified by sociodemographic category, and adjusted for number of American College of Rheumatology (ACR) member rheumatologists in the state and SES using a validated composite of US Census variables.
RESULTS
We identified 34,339 individuals with SLE (prevalence 143.7 per 100,000) and 7,388 (21.5%) with LN (prevalence 30.9 per 100,000). SLE prevalence was 6 times higher among women, nearly double in African American compared to white women, and highest in the US South. LN prevalence was higher among all racial/ethnic minority groups compared to whites. The areas with lowest SES had the highest prevalence; areas with the fewest ACR rheumatologists had the lowest prevalence. SLE incidence was 23.2 per 100,000 person-years and LN incidence was 6.9 per 100,000 person-years, with similar sociodemographic trends.
CONCLUSION
In this nationwide Medicaid population, there was sociodemographic variation in SLE and LN prevalence and incidence. Understanding the increased burden of SLE and its complications in this low-income population has implications for resource allocation and access to subspecialty care.



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