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结直肠切除术对无结直肠癌患者心血管疾病风险的影响。

The impact of colectomy on the risk of cardiovascular disease among patients without colorectal cancer.

机构信息

Division of Colorectal Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.

College of Medicine, Tzu Chi University, Hualien, Taiwan.

出版信息

Sci Rep. 2020 Feb 19;10(1):2925. doi: 10.1038/s41598-020-59640-w.

Abstract

Cardiometabolic disorders were discussed and might be changed by microbiota in recent years. Since the colon acts as the primary reservoir of microbiota, we designed the present study to explore the association between colectomy and cardiovascular disease (CVD). We identified a total of 18,424 patients who underwent colectomy between 2000-2012 for reasons other than colorectal cancer from the National Health Insurance Research Database of Taiwan. Patients were matched with 18,424 patients without colectomy using a 1:1 propensity score by age, sex, and comorbidity. Cox proportional-hazards regression was used to assess the risk of CVD. Patients with colectomy were found to be at lower risk of CVD (hazard ratio [HR]: 0.95, 95% confidence interval [CI] = 0.90-0.99) than patients without colectomy. Stratified analysis according to the type of surgery revealed patients who underwent cecectomy and right hemicolectomy were at lower risk of CVD (cecectomy: adjusted HR [aHR] = 0.77, 95% CI = 0.64-0.94; right hemicolectomy: aHR = 0.88, 95% CI = 0.82-0.96). Patients who underwent left hemicolectomy were at higher risk of CVD (aHR = 1.19, 95% CI = 1.08-1.32). Our results indicate that the different colectomy procedures influence the risk for the CVD differently.

摘要

近年来,人们讨论了心脏代谢疾病可能会受到微生物群的影响。由于结肠是微生物群的主要储存库,我们设计了本研究来探讨结肠切除术与心血管疾病(CVD)之间的关联。我们从台湾全民健康保险研究数据库中确定了 18424 名 2000 年至 2012 年间因非结直肠癌而接受结肠切除术的患者。通过年龄、性别和合并症对患者进行 1:1 倾向评分匹配,共匹配了 18424 名未接受结肠切除术的患者。采用 Cox 比例风险回归评估 CVD 的风险。与未接受结肠切除术的患者相比,接受结肠切除术的患者患 CVD 的风险较低(风险比[HR]:0.95,95%置信区间[CI] = 0.90-0.99)。根据手术类型进行的分层分析显示,接受盲肠切除术和右半结肠切除术的患者患 CVD 的风险较低(盲肠切除术:调整 HR[aHR] = 0.77,95%CI = 0.64-0.94;右半结肠切除术:aHR = 0.88,95%CI = 0.82-0.96)。接受左半结肠切除术的患者患 CVD 的风险较高(aHR = 1.19,95%CI = 1.08-1.32)。我们的结果表明,不同的结肠切除术程序对 CVD 的风险有不同的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1adc/7031401/f506a5652de1/41598_2020_59640_Fig1_HTML.jpg

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