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显微镜下结肠炎与胆囊切除术或阑尾切除术无关。

Microscopic colitis is not associated with cholecystectomy or appendectomy.

作者信息

Laing Aran W, Pardi Darrell S, Loftus Edward V, Smyrk Thomas C, Kammer Patricia P, Tremaine William J, Schleck Cathy D, Harmsen W Scott, Zinsmeister Alan R, Melton L Joseph, Sandborn William J

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.

出版信息

Inflamm Bowel Dis. 2006 Aug;12(8):708-11. doi: 10.1097/00054725-200608000-00006.

Abstract

BACKGROUND

Microscopic colitis is a common cause of chronic watery diarrhea of unknown origin. Some patients develop diarrhea after cholecystectomy, and some patients with microscopic colitis have evidence of bile acid malabsorption. However, the association between cholecystectomy and microscopic colitis has not been studied. A protective effect of appendectomy on the development of ulcerative colitis also has been reported, but its relationship with microscopic colitis has not been studied. The aim of this study was to assess cholecystectomy and appendectomy as potential risk factors for the development of microscopic colitis in a nested case-control study.

MATERIALS AND METHODS

Using the Rochester Epidemiology Project, we identified all Olmsted County (Minnesota) residents with an initial diagnosis of microscopic colitis between January 1, 1985, and December 31, 2001. Rates of antecedent cholecystectomy or appendectomy in patients with microscopic colitis were compared with age-, gender-, and calendar year-matched community controls through conditional logistic regression.

RESULTS

Microscopic colitis was identified in 130 cases. Cholecystectomy preceded the diagnosis of microscopic colitis in 12 cases (9%) compared with 17 (13%) in the control group (odds ratio [OR] 0.7; 95% CI 0.3-1.5). Appendectomy preceded the diagnosis of microscopic colitis in 39 subjects (30%) compared with 28 (22%) in the control group (OR 1.6; 95% CI 0.9-2.7). Similar results were obtained when the analysis was restricted to microscopic colitis subtype (lymphocytic colitis or collagenous colitis).

CONCLUSIONS

In this population-based nested case-control study, no significant association was seen between cholecystectomy or appendectomy and the development of microscopic colitis or its subtypes.

摘要

背景

显微镜下结肠炎是不明原因慢性水样腹泻的常见病因。一些患者在胆囊切除术后出现腹泻,一些显微镜下结肠炎患者有胆汁酸吸收不良的证据。然而,胆囊切除术与显微镜下结肠炎之间的关联尚未得到研究。阑尾切除术对溃疡性结肠炎发展的保护作用也有报道,但其与显微镜下结肠炎的关系尚未得到研究。本研究的目的是在一项巢式病例对照研究中评估胆囊切除术和阑尾切除术作为显微镜下结肠炎发生的潜在危险因素。

材料与方法

利用罗切斯特流行病学项目,我们确定了1985年1月1日至2001年12月31日期间首次诊断为显微镜下结肠炎的所有奥尔姆斯特德县(明尼苏达州)居民。通过条件逻辑回归,将显微镜下结肠炎患者先前进行胆囊切除术或阑尾切除术的比例与年龄、性别和日历年份匹配的社区对照进行比较。

结果

共确定了130例显微镜下结肠炎病例。12例(9%)显微镜下结肠炎患者在诊断前进行了胆囊切除术,而对照组为17例(13%)(比值比[OR]0.7;95%可信区间0.3 - 1.5)。39例(30%)受试者在显微镜下结肠炎诊断前进行了阑尾切除术,而对照组为28例(22%)(OR 1.6;95%可信区间0.9 - 2.7)。当分析仅限于显微镜下结肠炎亚型(淋巴细胞性结肠炎或胶原性结肠炎)时,得到了类似的结果。

结论

在这项基于人群的巢式病例对照研究中,未发现胆囊切除术或阑尾切除术与显微镜下结肠炎及其亚型的发生之间存在显著关联。

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