Chen Chien-Hua, Lin Cheng-Li, Cheng Yu-Shu, Jeng Long-Bin
DigestiveDisease Center, Show-Chwan Memorial Hospital, Changhua, Taiwan.
Department of Food Science and Technology, Hungkuang University, Taichung, Taiwan.
Obes Surg. 2017 Jun;27(6):1604-1611. doi: 10.1007/s11695-016-2515-3.
We assessed the risk of coronary heart disease (CHD) after subtotal gastrectomy with Billroth II anastomosis (SGBIIA) for peptic ulcer disease (PUD).
The Taiwan National Health Insurance Research Database was used, and 6160 patients undergoing SGBIIA for PUD were identified as the surgical cohort. A total of 24,540 patients from the PUD population not undergoing surgery selected by frequency-matching were identified as the non-surgical cohort. All patients were followed until the end of 2011 to measure the incidence of CHD.
The cumulative incidence of CHD was lower in patients with SGBIIA than in those without surgery (16.9 vs 22.9 per 1000 person-year, adjusted hazard ratio [aHR] = 0.79, 95% confidence interval [CI] = 0.71-0.88). The risk of CHD, either acute coronary syndrome (ACS) (aHR = 0.83, 95% CI = 0.75-0.91) or other non-ACS CHD (aHR = 0.78, 95% CI = 0.68-0.88), was lower for the SGBIIA cohort than for the non-surgery cohort (aHR = 0.79, 95% CI = 0.71-0.88) after adjusting for age and the comorbidities of hypertension, diabetes mellitus, hyperlipidemia, stroke, congestive heart failure, chronic kidney disease, and chronic obstructive pulmonary disease.
We found SGBIIA is associated with a reduced risk of CHD for PUD patients.
我们评估了因消化性溃疡疾病（PUD）行毕罗Ⅱ式吻合术的胃大部切除术（SGBIIA）后冠心病（CHD）的风险。
使用台湾国民健康保险研究数据库，确定6160例行SGBIIA治疗PUD的患者作为手术队列。通过频率匹配从未接受手术的PUD人群中选取24540例患者作为非手术队列。所有患者随访至2011年底，以测量CHD的发病率。
SGBIIA患者的CHD累积发病率低于未手术患者（每1000人年分别为16.9和22.9，调整后风险比[aHR]=0.79，95%置信区间[CI]=0.71-0.88）。在调整年龄以及高血压、糖尿病、高脂血症、中风、充血性心力衰竭、慢性肾病和慢性阻塞性肺疾病等合并症后，SGBIIA队列的CHD风险，无论是急性冠状动脉综合征（ACS）（aHR=0.83，95%CI=0.75-0.91）还是其他非ACS的CHD（aHR=0.78，95%CI=0.68-0.88），均低于非手术队列（aHR=0.79，95%CI=0.71-0.88）。
我们发现SGBIIA与PUD患者CHD风险降低相关。
