Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Section 1, San-Min Road, Taichung, 40343, Taiwan.
Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Clin Rheumatol. 2018 Nov;37(11):3009-3016. doi: 10.1007/s10067-018-4192-1. Epub 2018 Jul 3.
The appendix is involved in immune function, and an appendectomy may alter the immune system. Studies evaluating the relationship between previous appendectomy and the risk of systemic lupus erythematosus (SLE) are lacking. This nationwide cohort study investigated the incidence and risk of SLE in patients who underwent appendectomy. Patients aged > 20 years who received appendectomy from 2000 to 2011 were identified from the National Health Insurance Research Database and assigned to the appendectomy cohort. Patients without appendectomy were randomly selected from the NHIRD and assigned to the control cohort; they were frequency matched to each study patient at a 4:1 ratio by sex, age, and index year. All patients were followed until SLE diagnosis, withdrawal from the National Health Insurance program, or the end of 2011. We used Cox models to estimate the hazard ratio (HR) and 95% confidence interval (CI) to compare the risk of SLE between the appendectomy and control cohorts. From 23.74 million people in the cohort, 80,582 patients undergoing appendectomy and 323,850 patients without appendectomy were followed for 723,438 and 2,931,737 person-years, respectively. The appendectomy cohort had a 2.04-fold higher risk of SLE than the control cohort (adjusted HR = 2.04, 95% CI = 1.52-2.76). Women aged ≤ 49 years who underwent appendectomy had a 2.27-fold higher risk of SLE than the corresponding controls (adjusted HR = 2.27, 95% CI = 1.62-3.19). Women aged ≤ 49 years who underwent appendectomy have a significantly higher risk of SLE.
阑尾参与免疫功能，阑尾切除术可能会改变免疫系统。评估阑尾切除术与系统性红斑狼疮（SLE）风险之间关系的研究尚缺乏。本全国性队列研究调查了接受阑尾切除术的患者中 SLE 的发病率和风险。从 2000 年至 2011 年，从国家健康保险研究数据库中确定了接受阑尾切除术的年龄>20 岁的患者，并将其分配到阑尾切除术队列中。从 NHIRD 中随机选择未接受阑尾切除术的患者，并将其分配到对照组；按照性别、年龄和索引年以 4:1 的比例与每个研究患者进行频数匹配。所有患者均随访至 SLE 诊断、退出国家健康保险计划或 2011 年底。我们使用 Cox 模型来估计风险比（HR）和 95%置信区间（CI），以比较阑尾切除术和对照组之间 SLE 的风险。在队列中的 2374 万人中，有 80582 名接受阑尾切除术的患者和 323850 名未接受阑尾切除术的患者分别随访了 723438 和 2931737 人年。与对照组相比，阑尾切除术队列患 SLE 的风险高 2.04 倍（调整 HR=2.04，95%CI=1.52-2.76）。接受阑尾切除术的≤49 岁女性患 SLE 的风险比相应对照组高 2.27 倍（调整 HR=2.27，95%CI=1.62-3.19）。接受阑尾切除术的≤49 岁女性患 SLE 的风险显著增加。
