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.
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]
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)。
作者:admin@医学,生命科学 2011-08-31 17:16