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炎性肠病发病初期行阑尾切除术的治疗意义
title: Protective role of appendicectomy on onset and severity of ulcerative colitis and Crohn's disease.
author: Radford-Smith GL, Edwards JE, Purdie DM, Pandeya N, Watson M, Martin NG, Green A, Newman B, Florin TH.
source: Gut. 2002 Dec;51:808-13.
abstract:
BACKGROUND AND AIMS: Recent studies on appendicectomy rates in ulcerative colitis and Crohn's disease have generally not addressed the effect of appendicectomy on disease characteristics. The aims of this study were to compare appendicectomy rates in Australian inflammatory bowel disease patients and matched controls, and to evaluate the effect of prior appendicectomy on disease characteristics.
METHODS: Patients were ascertained from the Brisbane Inflammatory Bowel Disease database. Controls matched for age and sex were randomly selected from the Australian Twin Registry. Disease characteristics included age at diagnosis, disease site, need for immunosuppression, and intestinal resection.
RESULTS: The study confirmed the significant negative association between appendicectomy and ulcerative colitis (odds ratio (OR) 0.23, 95% confidence interval (CI) 0.14-0.38; p<0.0001) and found a similar result for Crohn's disease once the bias of appendicectomy at diagnosis was addressed (OR 0.34, 95% CI 0.23-0.51; p<0.0001). Prior appendicectomy delayed age of presentation for both diseases and was statistically significant for Crohn's disease (p=0.02). In ulcerative colitis, patients with prior appendicectomy had clinically milder disease with reduced requirement for immunosuppression (OR 0.15, 95% CI 0.02-1.15; p=0.04) and proctocolectomy (p=0.02).
CONCLUSIONS: Compared with patients without prior appendicectomy, appendicectomy before diagnosis delays disease onset in ulcerative colitis and Crohn's disease and gives rise to a milder disease phenotype in ulcerative colitis.
PMID: 12427781 [PubMed - indexed for MEDLINE]
文题：炎性肠病发病初期行阑尾切除术的治疗意义
摘要：背景及目的：近期关于在溃疡性结肠炎及克隆氏病发病初期行阑尾切除术手术率的研究大多没有强调阑尾切除术对疾病特点的影响。本研究的目的是通过比较澳大利亚炎性肠病（IBD）患者及对照行阑尾切除术手术率，评价早期切除阑尾对IBD疾病的特点。
方法：患者由Brisbane炎性肠病数据库所确诊，对照从澳大利亚Twin Registry随机选取，并按照年龄及性别配对。疾病特征包括诊断时的年龄，发病部位，是否需免疫抑制剂，是否需肠切除。
结果：研究确证了阑尾切除术与溃疡性结肠炎之间显著的负相关（OR 0.23, 95%CI 0.14-0.38,p<0.0001）。在克隆氏病，在纠正了诊断时行阑尾切除术的偏倚以后，也有相似结果(OR 0.34, 95% CI 0.23-0.51; p<0.0001)，阑尾切除术延迟了两种疾病出现症状的年龄，并且在克隆氏病中有统计学意义(p=0.02)。行阑尾切除术后，溃疡性结肠炎患者的临床症状减轻，并且更少需要免疫抑制剂及肠切除治疗(p=0.02)。
结论：与不切除阑尾的患者相比，诊断前切除阑尾延迟了溃疡性结肠炎及克隆氏病的发病，并且溃疡性结肠炎的症状也有所减轻。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-08-31 17:16
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