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台湾地区的痴呆症与迷走神经切断术:一项基于人群的队列研究。

Dementia and vagotomy in Taiwan: a population-based cohort study.

作者信息

Lin Shih-Yi, Lin Cheng-Li, Wang I-Kuan, Lin Cheng-Chieh, Lin Chih-Hsueh, Hsu Wu-Huei, Kao Chia-Hung

机构信息

Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan.

Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan.

出版信息

BMJ Open. 2018 Mar 30;8(3):e019582. doi: 10.1136/bmjopen-2017-019582.

Abstract

OBJECTIVE

Truncal vagotomy is associated with a decreased risk of subsequent Parkinson disease (PD), although the effect of vagotomy on dementia is unclear. In response, we investigated the risk of dementia in patients who underwent vagotomy.

SETTING

Population-based cohort study.

PARTICIPANTS

A total of 155 944 patients who underwent vagotomy (vagotomy cohort) and 155 944 age-matched, sex-matched and comorbidity-matched controls (non-vagotomy cohort) were identified between 2000 and 2011.

PRIMARY AND SECONDARY OUTCOME MEASURES

All patient data were tracked until the diagnosis of dementia, death or the end of 2011. The cumulative incidence of subsequent dementia and HRs were calculated.

RESULTS

The mean ages of the study patients in the vagotomy and non-vagotomy cohorts were 56.6±17.4 and 56.7±17.3 years, respectively. The overall incidence density rate for dementia was similar in the vagotomy and non-vagotomy cohorts (2.43 and 2.84 per 1000 person-years, respectively). After adjustment for age, sex and comorbidities such as diabetes, hypertension, hyperlipidaemia, stroke, depression, coronary artery disease and PD, the patients in the vagotomy cohort were determined to not be at a higher risk of dementia than those in the non-vagotomy cohort (adjusted HR=1.09, 95% CI 0.87 to 1.36). Moreover, the patients who underwent truncal vagotomy were not associated with risk of dementia (adjusted HR=1.04, 95% CI 0.87 to 1.25), compared with the patients who did not undergo vagotomy.

CONCLUSION

Vagotomy, either truncal or selective, is not associated with risk of dementia.

摘要

目的

迷走神经干切断术与后续帕金森病(PD)风险降低相关,尽管迷走神经切断术对痴呆的影响尚不清楚。为此,我们调查了接受迷走神经切断术患者的痴呆风险。

设置

基于人群的队列研究。

参与者

在2000年至2011年期间,共确定了155944例接受迷走神经切断术的患者(迷走神经切断术队列)和155944例年龄、性别和合并症匹配的对照者(非迷走神经切断术队列)。

主要和次要结局指标

追踪所有患者数据直至痴呆诊断、死亡或2011年底。计算后续痴呆的累积发病率和风险比(HRs)。

结果

迷走神经切断术队列和非迷走神经切断术队列中研究患者的平均年龄分别为56.6±17.4岁和56.7±17.3岁。迷走神经切断术队列和非迷走神经切断术队列中痴呆的总体发病率密度率相似(分别为每1000人年2.43例和2.84例)。在对年龄、性别和合并症(如糖尿病、高血压、高脂血症、中风、抑郁症、冠状动脉疾病和PD)进行调整后,确定迷走神经切断术队列中的患者患痴呆的风险并不高于非迷走神经切断术队列中的患者(调整后的HR=1.09,95%置信区间0.87至1.36)。此外,与未接受迷走神经切断术的患者相比,接受迷走神经干切断术的患者与痴呆风险无关(调整后的HR=1.04,95%置信区间0.87至1.25)。

结论

迷走神经干切断术或选择性迷走神经切断术均与痴呆风险无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69b9/5884346/17fb8094758c/bmjopen-2017-019582f01.jpg

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