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憩室病与结肠冗长之间的相关性。

The correlation between diverticulosis and redundant colon.

作者信息

Cuda Tahleesa, Gunnarsson Ronny, de Costa Alan

机构信息

Cairns Clinical School, College of Medicine and Dentistry, James Cook University, Cairns, QLD, 4870, Australia.

Department of Surgery, Cairns Private Hospital, Cairns, QLD, Australia.

出版信息

Int J Colorectal Dis. 2017 Nov;32(11):1603-1607. doi: 10.1007/s00384-017-2894-5. Epub 2017 Sep 20.

Abstract

BACKGROUND

Diverticulosis and redundant colon are colonic conditions for which underlying pathophysiology, management and prevention are poorly understood. Historical papers suggest an inverse relationship between these two conditions. However, no further attempt has been made to validate this relationship. This study set out to assess the correlation between diverticulosis and colonic redundancy.

METHODS

Redundant colon, diverticulosis and patient demographics were recorded during colonoscopy. Multivariate binary logistic regression was performed with redundant colon as the dependent variable and age, gender and diverticulosis as independent variables. Nagelkerke R and a receiver operator curve were calculated to assess goodness of fit and internally validate the multivariate model.

RESULTS

Redundant colon and diverticulosis were diagnosed in 31 and 113 patients, respectively. The probability of redundant colon was increased by female gender odds ratio (OR) 8.4 (95% CI 2.7-26, p = 0.00020) and increasing age OR 1.7 (95% CI 1.1-2.6, p = 0.017). Paradoxically, diverticulosis strongly reduced the probability of redundant colon with OR of 0.12 (95% CI 0.42-0.32, p = 0.000039). The Nagelkerke R for the multivariate model was 0.29 and the area under the curve at ROC analysis was 0.81 (95% CI 0.73-0.90 p-value 3.1 × 10).

CONCLUSIONS

This study found an inverse correlation between redundant colon and diverticulosis, supporting the historical suggestion that the two conditions rarely occur concurrently. The underlying principle for this relationship remains to be found. However, it may contribute to the understanding of the aetiology and pathophysiology of these colonic conditions.

摘要

背景

憩室病和结肠冗长是结肠疾病,其潜在的病理生理学、管理和预防尚不清楚。历史文献表明这两种疾病之间存在反比关系。然而,尚未进一步尝试验证这种关系。本研究旨在评估憩室病与结肠冗长之间的相关性。

方法

在结肠镜检查期间记录结肠冗长、憩室病和患者人口统计学信息。以结肠冗长为因变量,年龄、性别和憩室病为自变量进行多变量二元逻辑回归。计算Nagelkerke R和受试者操作特征曲线以评估拟合优度并对多变量模型进行内部验证。

结果

分别在31例和113例患者中诊断出结肠冗长和憩室病。女性性别优势比(OR)为8.4(95%可信区间2.7 - 26,p = 0.00020)以及年龄增长OR为1.7(95%可信区间1.1 - 2.6,p = 0.017)会增加结肠冗长的可能性。矛盾的是,憩室病会显著降低结肠冗长的可能性,OR为0.12(95%可信区间0.42 - 0.32,p = 0.000039)。多变量模型的Nagelkerke R为0.29,ROC分析的曲线下面积为0.81(95%可信区间0.73 - 0.90,p值3.1×10)。

结论

本研究发现结肠冗长与憩室病之间存在负相关,支持了这两种疾病很少同时发生的历史观点。这种关系的潜在原理仍有待发现。然而,它可能有助于理解这些结肠疾病的病因和病理生理学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/364e/5635100/ad047bc2f350/384_2017_2894_Fig1_HTML.jpg

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