利用台灣健保資料庫進行二尖瓣膜脫垂與恐慌症之相關性研究

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Title:	利用台灣健保資料庫進行二尖瓣膜脫垂與恐慌症之相關性研究
Authors:	李東穎;Ying-Dong, Lee
Contributors:	生物資訊與醫學工程學系
Keywords:	二尖瓣膜脫垂、恐慌症、風險因子
Date:	2017
Issue Date:	2018-05-31 03:56:15 (UTC+0)
Publisher:	亞洲大學
Abstract:	二尖瓣膜脫垂是在瓣膜疾病中最為常見的一種，而大多數的成因是遺傳先天的影響，而嚴重的話也會引響心臟血液流動的運作甚至是心臟衰竭。恐慌症是屬於慢性精神疾病，大多數的診斷會誤認是心臟病發作。目前台灣的研究較少關於二尖瓣膜脫垂疾病，然而恐慌症與二尖瓣膜脫垂的發病症狀有其相似之處，所以，本研究想知道二尖瓣膜脫垂與恐慌症間的關聯性，故利用台灣健保資料庫來分析統計兩者間之相關性，以瞭解罹患二尖瓣膜脫垂患者是否較未曾罹患二尖瓣膜脫垂患者容易發生恐慌症。本研究以2006～2010年二尖瓣膜脫垂之個案共18,193人，與同時期未二尖瓣膜脫垂之患者共694,149人為研究對象；往後追蹤至2013年恐慌症的人數分別為674人與5,044人。研究中使用獨立樣本t檢定、卡方檢定、Cox比例風險模式，探討相關因素及二尖瓣膜脫垂與恐慌症的關聯性。從資料分析可得知，病患的性別、年齡、查爾森共病指標、二尖瓣膜脫垂與恐慌症之風險因子、都市化程度、地理位置、投保金額在罹患二尖瓣膜脫垂未非罹患二尖瓣膜脫垂間有顯著差異。且研究結果指出罹患二尖瓣膜脫垂患者較未罹患二尖瓣膜脫垂患者容易罹患恐慌症，其調整過後的HR值為3.84(95%的信賴區間為3.52至4.19)。 Mitral valve prolapse is the most common disease, and it might seriously affect the flow of blood or heart failure. Furthermore, the causes of mitral valve prolapse is congenital inheritance. On the other hand, panic disorder is a chronic mental illness, most of them might be error diagnosis as heart attack. At present, there are few studies about mitral valve prolapse disease in Taiwan. However, the symptoms of panic disorder are similar to mitral valve prolapse. So, the purpose of this study is to understand the relevance of mitral valve prolapse and panic disorder through the National Health Insurance Research Database (NHIRD) of Taiwan. There were 18,193 patients of mitral valve prolapse, and 694,149 patients without mitral valve prolapse in NHIRD between 2006 and 2010. The sample t-test, chi-square test, and Cox-proportional model were used to analyze association between mitral valve prolapse and panic disorder. The results show the difference between patients with and without mitral valve prolapse are significantly in gender, age, Charlson comorbidity index (CCI), degree of urbanization, geographical location, and the amount of insurance. The modify HR is 3.84 (95% confidence interval is 3.52-4.19), it reveals patients with mitral valve prolapse are more easily to get panic disorder than patients without mitral valve prolapse.
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