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阑尾切除术史与帕金森病无关。

Appendectomy History is not Related to Parkinson's Disease.

作者信息

Yilmaz Rezzak, Bayram Ece, Ulukan Çağrı, Altınok Mustafa Kemal, Akbostancı Muhittin Cenk

机构信息

Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany.

Department of Interdisciplinary Neuroscience, Ankara University, Institute of Health Sciences, Ankara, Turkey.

出版信息

J Parkinsons Dis. 2017;7(2):347-352. doi: 10.3233/JPD-171071.

Abstract

BACKGROUND

It has been suggested that appendectomy may modify the emergence of Parkinson's disease (PD) by affecting the retrograde transport of α-synuclein (α-syn) from the gastrointestinal system.

OBJECTIVE

To explore the possible role of appendectomy on PD.

METHODS

The retrospective data of the 1625 patients (839 PD, 633 non-α-syn parkinsonism and 153 controls) were compared. Disease specific measures between PD patients with (n = 69) and without (n = 770) appendectomy were also evaluated.

RESULTS

The prevalence of appendectomy was not significantly lower in the PD group (8.2%) compared to the other groups (8.4% and 7.9%, p = 0.98), and the odds of having PD against other diagnoses (OR) were not significantly different in the appendectomy group (OR = 0.99, p = 0.96). No difference was determined between PD patients with and without appendectomy with respect to the age of disease onset, disease duration and severity. Appendectomy-first symptom interval was not determined to be related with PD diagnosis (hazard ratio = 1.12, p = 0.39) and did not predict disease severity in the PD group (OR = 0.99, p = 0.54). Age of appendectomy (lower or higher than 20) also did not affect future PD diagnosis (Relative Risk = 0.9, p = 0.54) or the disease severity.

CONCLUSIONS

The results of the study suggest no effect of appendectomy on the emergence and clinical manifestations of PD. The removal of the appendix is possibly not sufficient to suppress the exposure of the brain stem to α-syn via vagal retrograde transport. Further studies are needed to elucidate the role of appendix in PD.

摘要

背景

有人提出,阑尾切除术可能通过影响α-突触核蛋白(α-syn)从胃肠道的逆行运输来改变帕金森病(PD)的发生。

目的

探讨阑尾切除术对PD的可能作用。

方法

比较了1625例患者(839例PD、633例非α-syn帕金森综合征和153例对照)的回顾性数据。还评估了接受(n = 69)和未接受(n = 770)阑尾切除术的PD患者之间的疾病特异性指标。

结果

与其他组(8.4%和7.9%,p = 0.98)相比,PD组的阑尾切除术患病率(8.2%)无显著降低,阑尾切除术组患PD相对于其他诊断的比值比(OR)无显著差异(OR = 0.99,p = 0.96)。接受和未接受阑尾切除术的PD患者在疾病发病年龄、病程和严重程度方面无差异。阑尾切除术后至首次出现症状的间隔时间与PD诊断无关(风险比 = 1.12,p = 0.39),也不能预测PD组的疾病严重程度(OR = 0.99,p = 0.54)。阑尾切除术的年龄(低于或高于20岁)也不影响未来的PD诊断(相对风险 = 0.9,p = 0.54)或疾病严重程度。

结论

研究结果表明阑尾切除术对PD的发生和临床表现无影响。切除阑尾可能不足以抑制脑干通过迷走神经逆行运输接触α-syn。需要进一步研究以阐明阑尾在PD中的作用。

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