Rutgeerts P, D'Haens G, Hiele M, Geboes K, Vantrappen G
Department of Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
Gastroenterology. 1994 May;106(5):1251-3. doi: 10.1016/0016-5085(94)90016-7.
BACKGROUND/AIMS: Defining risk factors for ulcerative colitis (UC) is important to better understand the pathogenesis of this idiopathic disease. One factor modulating the disease is smoking. A pilot study showed the absence of appendectomy in the medical history of patients with ulcerative colitis. The aim of the present case control study was to compare the relative risk of developing UC after appendectomy with the relative risk of developing UC with an intact appendix.
One hundred seventy-four (84 females and 90 males, mean age 34.9 years) consecutive UC patients examined at our inflammatory bowel disease clinic or hospital ward, were included. Fifty-six had pancolitis (32%) and 118 (68%) suffered from left-sided colitis. The control group consisted of 161 consecutive patients examined at the orthopedic clinic (86 females and 75 males, mean age 40.9 years).
Two parameters, absence of appendectomy and smoking, were closely related to the development of UC. Before the onset of UC, only 1 of the 174 patients (0.6%) had undergone an appendectomy. Of the 161 controls, 41 (25.4%) had undergone an appendectomy. The difference between the two groups was highly significant with an odds ratio of 59.1 (95% CI, 18-189; P < 0.001). The relative risk of getting the disease associated with nonsmoking was 2.95 (95% CI, 1.69-5.17).
Appendectomy is a protective factor against UC.
背景/目的：明确溃疡性结肠炎（UC）的危险因素对于更好地理解这种特发性疾病的发病机制至关重要。一个影响该疾病的因素是吸烟。一项初步研究显示，溃疡性结肠炎患者的病史中无阑尾切除术。本病例对照研究的目的是比较阑尾切除术后发生UC的相对风险与阑尾完整时发生UC的相对风险。
纳入在我们的炎症性肠病诊所或医院病房接受检查的174例（84例女性和90例男性，平均年龄34.9岁）连续性UC患者。56例患有全结肠炎（32%），118例（68%）患有左侧结肠炎。对照组由在骨科诊所接受检查的161例连续性患者组成（86例女性和75例男性，平均年龄40.9岁）。
两个参数，即无阑尾切除术和吸烟，与UC的发生密切相关。在UC发病前，174例患者中只有1例（0.6%）接受过阑尾切除术。在161例对照组中，41例（25.4%）接受过阑尾切除术。两组之间的差异非常显著，优势比为59.1（95%可信区间，18 - 189；P < 0.001）。与不吸烟相关的患病相对风险为2.95（95%可信区间，1.69 - 5.17）。
阑尾切除术是预防UC的一个保护因素。
