Department of Medical Research, Taitung MacKay Memorial Hospital, No. 1, Lane 303, Changsha Street, Taitung City 95054, Taiwan.
Institute of Public Health and Department of Public Health, School of Medicine, National Yang-Ming University, No. 155, Section 2, Li-Nong St., Taipei 112, Taiwan.
Maturitas. 2018 Aug;114:27-33. doi: 10.1016/j.maturitas.2018.05.007. Epub 2018 May 19.
To assess the risk of stroke (and subtypes of stroke) in women after elective bilateral salpingo-oophorectomy at hysterectomy for benign diseases.
We conducted a nationwide population-based, retrospective cohort study using claims data from Taiwan's National Health Insurance program between 1997 and 2013. Women aged 20 years or more who underwent bilateral salpingo-oophorectomy at hysterectomy for benign diseases (n = 1083) were compared with women who did not undergo bilateral salpingo-oophorectomy at hysterectomy for benign diseases (n = 3903). The follow-up period ranged from 10 to 16 years. Age-adjusted (or unadjusted) and multivariate Cox proportional hazards regression models were used to estimate the risk of stroke between the two groups.
A diagnosis of stroke (and subtypes of stroke).
We did not find a significant association between bilateral salpingo-oophorectomy and the risk of incident stroke (or subtypes of stroke) over an average follow-up of 13 years. Among women aged 50 years or more who used estrogen therapy, the risk of developing stroke was 64% lower in those who had undergone bilateral salpingo-oophorectomy (hazard ratio, 0.36; 95% confidence interval, 0.16-0.79) than in those who had undergone hysterectomy only.
This study suggests that the use of estrogen after bilateral salpingo-oophorectomy at hysterectomy for benign diseases reduces the risk of stroke in women aged 50 years or more.
评估因良性疾病行子宫切除术时选择性双侧输卵管卵巢切除术（BSO）后女性发生中风（及中风亚型）的风险。
我们开展了一项基于人群的全国性回顾性队列研究，使用了台湾全民健康保险计划在 1997 年至 2013 年期间的理赔数据。1083 例因良性疾病行子宫切除术时接受双侧输卵管卵巢切除术的女性与 3903 例未行双侧输卵管卵巢切除术的女性进行比较。随访时间为 10 至 16 年。采用年龄调整（或未调整）和多变量 Cox 比例风险回归模型来估计两组之间中风的风险。
中风（及中风亚型）的诊断。
在平均 13 年的随访中，我们未发现双侧输卵管卵巢切除术与中风（及中风亚型）的发病风险之间存在显著关联。在年龄≥50 岁且使用雌激素治疗的女性中，与仅行子宫切除术的女性相比，行双侧输卵管卵巢切除术的女性中风发病风险降低 64%（风险比，0.36；95%置信区间，0.16-0.79）。
本研究表明，因良性疾病行子宫切除术时使用雌激素可降低年龄≥50 岁女性发生中风的风险。
