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路透社:胆囊切除术降低中风机率/秀传医院叶永祥医师 2019/07/24
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(路透社报导刊载)


路透社健康新闻纽约报导,根据一项新的回溯性世代研究显示,胆囊切除术可以降低得到中风的风险

NEW YORK (Reuters Health) - Cholecystectomy is associated with a reduced risk of stroke, according to a new retrospective cohort study.

 

根据此项调查发现,医师应建议胆结石的病人,采取预防中风的措施,特别是有高风险的病人。该研究作者之一,台湾彰滨秀传纪念医院叶永祥医师,透过电子邮件的方式接受路透社采访。

Based on the findings, physicians should advise their gallstone patients to take preventive measures against stroke, especially if they are at high risk, Dr. Yeh Yung-Hsiang of Show Chwan Memorial Hospital in Changhua, Taiwan, one of the study's authors, told Reuters Health by email.


先前研究发现,胆结石与心血管疾病死亡及脑中风之间,有著同样的关联性。叶永祥医师和其同事在201965日发表于Journal of Gastroenterology and Hepatology期刊上这样表示。

Previous studies have found an association between gallstone disease and cardiovascular disease and death, as well as stroke, Dr. Yung-Hsiang and colleagues note in the Journal of Gastroenterology and Hepatology, online June 5.


此研究里以胆结石病人做为比较,其中有155,356位接受胆囊切除术,另外155,356位没有接受胆囊切除术。

They compared 155,356 gallstone patients who underwent cholecystectomy and 155,356 patients with gallstones who did not have their gallbladder removed.


2000年至2012年,19,096位没有接受胆囊切除术的病人(17.8 /1,000人年)11,913位接受胆囊切除术的病人(10.6 /1,000人年),在发生中风的机率,接受胆囊切除术者在风险上有很显著性的降低,所有中风(风险比率0.60)、缺血性脑中风(风险比率0.60)出血性中风(风险比, 0.55)

From 2000-2012, 19,096 of patients without cholecystectomy (17.8/1,000 person-years) and 11,913 with cholecystectomy (10.6/1,000 person years) had a stroke. The risk was significantly decreased with cholecystectomy for all strokes (hazard ratio, 0.60), ischemic stroke (HR, 0.60) and hemorrhagic stroke (HR, 0.55).


无论是有症状或无症状的胆囊切除术病人,接受胆囊切除术的病人与无症状没有接受胆囊切除术的病人相比,得到中风的风险因子,有显著性的降低

Stroke risk was significantly lower for both asymptomatic and symptomatic gallstone patients after cholecystectomy, compared to asymptomatic patients who did not have their gallbladder removed.


 叶永祥医师告诉路透社记者 医生应对胆结石病人的潜在脑血管风险因子进行全面评估

"Physicians should make complete evaluation of underlying cerebrovascular risk factors for patients with gallstone disease," Dr. Yung-Hsiang told Reuters Health.

 

研究人员补充说明:胆结石会导致胆囊内胆汁滞留的发炎症状。急性或慢性发炎在脑血管事件中扮演著关键的角色。因此,我们假设胆囊切除术可以通过消除炎症机制来降低中风的风险。不过这些推论还需要进一步的研究来证实。

"Gallstones can lead to an inflammatory condition characterized by bile retention in the gallbladder," the researcher added. "The acute or chronic inflammation plays a crucial role in vascular events. So we assume that cholecystectomy could reduce stroke risk by eliminating (the) inflammatory mechanism. Still further studies need to be conducted to answer these questions."


 我们也计画调查胆囊切除术对于其它疾病的影响。

The researchers also plan to investigate the effects of cholecystectomy in other diseases.

 

来源出处:

SOURCE: https://bit.ly/2INn55s

J Gastroenterol Hepatol 2019.

 

感谢本研究团队 中医大许重义教授,高嘉鸿教授,林澄莉分析师,彰滨秀传魏诚佑主任,庄树宏医师