| 摘要: | 背景與目的：貧血是現今重要的全球性健康問題，也是臨床中常見的醫療情況。根據世界衛生組織(WHO)於2011年統計發現，全球約有43%的兒童、38%的孕婦以及29%的育齡女性患有貧血。缺鐵性貧血是目前最常見的貧血原因，我國「國民營養健康狀況變遷調查2013-2016年成果報告」之資料顯示，男性在19-64歲之貧血盛行率為9.8%，女性則為37.9%，其中在19-44歲之女性中發現儲鐵蛋白過低的比例為24.1%。隨著社會經濟之變遷，工業社會的激烈競爭造成耳蝸血管之緊張痙攣以及高齡化社會延伸出更多的老年血管性耳鳴。目前已發現60歲以下的缺鐵性病患與突發性聽力損失及合併聽力損失有相關性，有鑑於此，本研究欲探討20歲以上成年人之耳鳴狀況，並進一步分析與缺鐵性貧血之相關性，進而提供個案之預防保健諮詢、達到健康促進之目的。
研究方法：本研究使用的是全民健康保險研究資料庫。研究設計採回溯性世代研究法之病例對照研究法，應用SAS 9.4套裝軟體進行描述性與推論性(卡方、羅吉斯迴歸)統計分析。
研究結果：本研究共納入2010-2017年之耳鳴新診斷族群病例組共計366,634位，對照組共計1,099,947位，研究樣本共計1,466,581人。研究主要發現，以卡方檢定比較耳鳴族群與無耳鳴族群其罹患缺鐵性貧血在統計上達到顯著差異(P <0.001)。以羅吉斯迴歸分析影響研究變項與罹患耳鳴之結果中可發現，耳鳴族群與缺鐵性貧血在統計上達到顯著差異(P <0.001)。綜合本研究之結果可判斷其研究假說成立：缺鐵性貧血與耳鳴有統計上顯著之相關性。此結果也驗證了過去多篇文獻之研究結果，認為缺鐵性貧血與聽力的健康有著相互影響之機制。
結論：因缺鐵性貧血是常見的血液疾病，特別是女性族群，故建議相關臨床科醫師多留意缺鐵性貧血患者與耳鳴患者之間的相關性，以利盡早治療；地方衛生機關可安排衛生教育相關之工作坊，加強民眾的醫學知識，同時提高主動維護自我健康的責任感。
Introduction: The risk factors of tinnitus have been of great interests among researchers who aimed to prevent the development of tinnitus and to provide efficient early screening. Except those well-known risk factors, we’ve tried to search another possible factors from the literature review.
Objectives: The aim of this study is to assess the iron deficiency anemia (IDA) with Tinnitus in Taiwan.
Methods: Using the Taiwan National Health Insurance (NHI) Research Dataset, this study includes 366,634 patients with tinnitus as cases and 1,099,947 patients without tinnitus as controls. We will perform multivariate logistic regressions to evaluate the odds ratios (ORs) for prior IDA occurrence between patients with Tinnitus and controls.
Result: This study included a total of 366,634 cases of diagnosed tinnitus from 2010 to 2017, a total of 1,099,947 people in the control group, and a total of 1,466,581 people in the study sample. The main findings of the study are that the chi-square test is used to compare the tinnitus group and the non-tinnitus group in terms of iron-deficiency anemia with statistically significant differences (P <0.001). The logistic regression analysis of the results of the impact of research variables and tinnitus can be found that there is a statistically significant difference between the tinnitus population and iron deficiency anemia (P <0.001). Based on the results of this study, it can be judged that the research hypothesis is established: iron deficiency anemia and tinnitus are statistically significant. This result also validates the results of many previous literatures, which believe that iron deficiency anemia and hearing health have a mutual influence mechanism.
Conclusion: Because iron deficiency anemia is a common blood disease, especially among women, it is recommended that relevant clinicians pay more attention to the correlation between iron deficiency anemia patients and tinnitus patients to facilitate early treatment; local health agencies can arrange health education Related workshops strengthen people's medical knowledge and at the same time increase their sense of responsibility to actively maintain their own health. |
