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创伤患者行脾切除术后患II型糖尿病的风险增加:一项基于全国人口的研究。

Splenectomy in trauma patients is associated with an increased risk of postoperative type II diabetes: a nationwide population-based study.

作者信息

Wu Shih-Chi, Fu Chih-Yuan, Muo Chih-Hsin, Chang Yen-Jung

机构信息

Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.

Department of Trauma and Emergency Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.

出版信息

Am J Surg. 2014 Nov;208(5):811-816. doi: 10.1016/j.amjsurg.2014.03.003. Epub 2014 May 2.

Abstract

BACKGROUND

Animal studies indicate that splenocytes may act as precursors of β-islet secretory cells in the pancreas. This study aimed to assess the risk of postoperative type II diabetes after splenectomy in trauma patients.

METHODS

We used data from the Taiwan National Health Insurance hospitalized claims. Study 1 included 3,723 patients receiving splenectomy and 3,723 matched patients receiving other types of abdominal surgery. Study 2 included 5,996 patients with spleen injury and 5,996 matched patients with other types of abdominal injury. The hazard ratio for diabetes was estimated using the matched Cox proportional hazard regression model.

RESULTS

In trauma patients after surgery, those who received splenectomy had a 2-fold higher risk of diabetes compared with patients without splenectomy after a 3-year follow-up period. In the nonoperative group, there was no difference in diabetes risk between patients with splenic injury and those with other types of injury.

CONCLUSIONS

Splenectomy was associated with an increased risk of postoperative type II diabetes in trauma patients. Thus, there may be a role for the spleen in the development of diabetes.

摘要

背景

动物研究表明,脾细胞可能是胰腺中β胰岛分泌细胞的前体。本研究旨在评估创伤患者脾切除术后发生II型糖尿病的风险。

方法

我们使用了来自台湾国民健康保险住院理赔的数据。研究1纳入了3723例接受脾切除术的患者和3723例匹配的接受其他类型腹部手术的患者。研究2纳入了5996例脾损伤患者和5996例匹配的其他类型腹部损伤患者。使用匹配的Cox比例风险回归模型估计糖尿病的风险比。

结果

在术后创伤患者中,经过3年随访期后,接受脾切除术的患者患糖尿病的风险是未接受脾切除术患者的2倍。在非手术组中,脾损伤患者和其他类型损伤患者的糖尿病风险没有差异。

结论

脾切除术与创伤患者术后II型糖尿病风险增加有关。因此,脾脏可能在糖尿病的发生发展中起作用。

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