摘要
AIM： To determine whether prior appendectomy modifies the phenotype and severity of Crohn＇s disease. METHODS： Appendectomy status and smoking habits were specified by direct interview in 2838 patients consecutively seen between 1995 and 2004. Occurrence of complications and therapeutic needs were reviewed retrospectively. Additionally, annual disease activity was assessed prospectively between 1995 and 2004 in patients who had not had ileocecal resection and of a matched control group. RESULTS： Compared to 1770 non-appendectomized patients, appendectomized patients more than 5 years before Crohn＇s disease diagnosis （n=716） were more often females, smokers, with ileal disease. Cox regression showed that prior appendectomy was positively related to the risk of intestinal stricture （adjusted hazard ratio, 1.24; 95% confidence interval, 1.13 to 1.36; P=0.02） and inversely related to the risk of perianal fistulization （adjusted hazard ratio, 0.75; 95% confidence interval, 0.68 to 0.83; P=0.002）. No difference was observed between the two groups regarding the therapeutic needs, except for an increased risk of surgery in appendectomized patients, attributable to the increased prevalence of ileal disease. Between 1995 and 2004, Crohn＇s disease was active during 50% of years in appendectomized patients （1318 out of 2637 patientyears） and 51% in non-appendectomized patients （1454 out of 2841 patient-years; NS）. CONCLUSION： Prior appendectomy is associated with a more proximal disease and has an increased risk of stricture and a lesser risk of anal fistulization. However, the severity of the disease is unaffected.
瞄准：决定优先的阑尾切除术是否修改 Crohn 的疾病的显型和严厉。方法：阑尾切除术地位和吸烟习惯被直接会见在连续地在 1995 和 2004 之间看见的 2838 个病人指定。复杂并发症和治疗学的需要的出现回顾地被考察。另外，年度疾病活动在没有回盲肠切除术的病人并且一个匹配的控制组在 1995 和 2004 之间有希望地被估计。结果：比作 1770 个 non-appendectomized 病人，在 Crohn 的疾病诊断(n=716 ) 前的超过 5 年更经常是的 appendectomized 病人女性，吸烟者，与 i 一起忠实疾病。考克斯回归证明那优先的阑尾切除术是断然与肠的苛评的风险有关(调整危险比率， 1.24；95% 信心间隔， 1.13 ～ 1.36；P=0.02 ) 并且相反地与仙子的风险有关肛门成瘘 2. 造瘘术(调整危险比率， 0.75；95% 信心间隔， 0.68 ～ 0.83；P=0.002 ) 。没有差别关于治疗学的需要在二个组之间被观察，除了在 appendectomized 病人，的外科的增加的风险对 i 的增加的流行可归因忠实疾病。在 1995 和 2004 之间， Crohn 的疾病在在 appendectomized 病人的 50% 年期间是活跃的(1318 从 2637 耐心年) 并且 51% 在 non-appendectomized 病人(1454 从 2841 耐心年；NS ) 。结论：优先的阑尾切除术与更近似的疾病被联系并且有苛评的增加的风险和肛门成瘘 2. 造瘘术的更小的风险。然而，疾病的严厉是未受影响的。
