JAHA:胃旁路手术可减少心血管疾病危险因素和充血性心力衰竭的长期风险!

2017-05-28 xing.T MedSci原创

由此可见,胃旁路手术与主要心血管事件和充血性心力衰竭的发生风险降低相关。

肥胖及其与预期寿命缩短之间的关系已被证实,其中心血管疾病是导致死亡的主要原因之一。代谢性手术是严重肥胖的一种强有力干预手段,可以导致合并症和心血管危险因素改善。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在探讨代谢性手术与长期心血管事件之间的相关性。

研究人员招募了接受Roux-EN-Y胃旁路手术(RYGB)患者组成队列,并严格按照年龄、体重指数、性别、Framingham风险评分、吸烟史、使用降压药史、糖尿病状态以及日期匹配非手术对照患者。研究人员采用Cox回归对该研究的主要研究终点-主要心血管事件(心肌梗死卒中、充血性心脏衰竭)进行了评估。采用重复测量回归法评估了次要终点-纵向心血管危险因素。

手术之后,研究人员对RYGB患者和匹配的对照者(每个队列n=1724)随访了12年(整体中位随访为6.3年)。Kaplan-Meier分析显示RYGB患者队列主要复合心血管事件(P=0.017)和充血性心力衰竭(P=0.0077)显著减少。调整后的Cox回归模型证实RYGB组严重心血管事件有所降低(风险比为0.58,95%可信区间为0.42-0.82)。此外,研究人员也观察到RYGB组患者手术后心血管危险因素得到了改善(例如,10年心血管风险评分、总胆固醇、高密度脂蛋白、收缩压和糖尿病)。

由此可见,胃旁路手术与主要心血管事件和充血性心力衰竭的发生风险降低相关。

原始出处:

Peter N. Benotti,et al. Gastric Bypass Surgery Produces a Durable Reduction in Cardiovascular Disease Risk Factors and Reduces the Long‐Term Risks of Congestive Heart Failure.JAHA.2017. https://doi.org/10.1161/JAHA.116.005126

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    2017-06-01 往日如昨

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    0

  4. 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  5. 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topicName=长期风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267461, encodeId=3906126e46123, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498190, encodeId=a5cb149819034, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1591236, encodeId=c6791591236ac, content=<a href='/topic/show?id=390a2856950' target=_blank style='color:#2F92EE;'>#充血性心力衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28569, encryptionId=390a2856950, topicName=充血性心力衰竭)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d7ef17933838, createdName=tidiq, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587003, encodeId=f581158e00309, content=<a href='/topic/show?id=a4be8319879' target=_blank style='color:#2F92EE;'>#胃旁路手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83198, encryptionId=a4be8319879, topicName=胃旁路手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c5417414181, createdName=zlawrance, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204325, encodeId=737c20432583, content=文章不错,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue May 30 07:59:10 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204005, encodeId=ea54204005fd, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon May 29 11:57:33 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
    2017-05-30 zhaohui6731
  6. 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  7. 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  8. 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  9. 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encryptionId=9dfc518398d, topicName=心血管疾病危险因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Sun Feb 18 00:18:00 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205191, encodeId=fe2e205191c5, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Thu Jun 01 11:22:28 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401328, encodeId=bbc614013285c, content=<a href='/topic/show?id=80e89e0479a' target=_blank style='color:#2F92EE;'>#长期风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97047, encryptionId=80e89e0479a, 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target=_blank style='color:#2F92EE;'>#胃旁路手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83198, encryptionId=a4be8319879, topicName=胃旁路手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c5417414181, createdName=zlawrance, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204325, encodeId=737c20432583, content=文章不错,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue May 30 07:59:10 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204005, encodeId=ea54204005fd, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon May 29 11:57:33 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
    2017-05-30 1e10c84am36(暂无匿称)

    文章不错,拜读了

    0

  10. 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topicName=长期风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267461, encodeId=3906126e46123, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498190, encodeId=a5cb149819034, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1591236, encodeId=c6791591236ac, content=<a href='/topic/show?id=390a2856950' target=_blank style='color:#2F92EE;'>#充血性心力衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28569, encryptionId=390a2856950, topicName=充血性心力衰竭)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d7ef17933838, createdName=tidiq, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587003, encodeId=f581158e00309, content=<a href='/topic/show?id=a4be8319879' target=_blank style='color:#2F92EE;'>#胃旁路手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83198, encryptionId=a4be8319879, topicName=胃旁路手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c5417414181, createdName=zlawrance, createdTime=Tue May 30 14:18:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204325, encodeId=737c20432583, content=文章不错,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue May 30 07:59:10 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204005, encodeId=ea54204005fd, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon May 29 11:57:33 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
    2017-05-29 ylzr123

    感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!

    0

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关于Roux-en-Y胃旁路术(RYGB) 后症状的发生情况,几乎还没有基于人群的研究,而了解这些症状可能的预测因素对预防很重要。因此研究者对2238名RYGH术后患者进行了一项调查,探究患者整体健康、患病率、医疗和营养的预测因子等,以及RYGB术后症状和生活质量。该研究还纳入了89名性别和BMI与2238名手术患者相匹配的未进行RYGB手术的人群。研究者以RYGB术后自我报道的症状发生率和严重性

Circulation:减肥和心力衰竭—胃旁路手术与强化改变生活方式对比

这项针对2个全国性登记中心的研究显示胃旁路手术后肥胖心衰发生率大约相当于强化生活方式改变的一半。

Arch Surg:减肥术后成瘾物使用风险升高

     近期一项前瞻性研究表明,患者在接受减肥手术(WLS)后的成瘾物使用风险升高。特别是接受腹腔镜Roux-EN-Y胃旁路手术的患者,可能发生术后饮酒风险升高。该研究是采用纵向调查数据显示WLS术后成瘾物使用增加的最早研究之一。研究在2012年10月15日在线发表于《外科学文献》(Arch Surg)杂志。   该研究旨在评估治疗肥胖症减肥手术(WLS)前后的成瘾物使用情况。减肥

Am J Clin Nutr:胃旁路术后3年的营养摄入变化

Roux-en-Y胃旁路手术(RYGB)对体重的影响已经得到了充分的研究和证明,但是RYGB术后能量和营养素的摄入、能量消耗以及身体各组份的变化相关研究却很少。因此研究者对肥胖女性患者进行了研究,评估患者在RYGB术后3年内能量和营养素的摄入、身体组份、基础代谢率(BMR)。该前瞻性观察性研究共纳入16名肥胖女性患者,平均(SEM)BMI是44.1(1.6)kg/m(2)。根据时间将其分为6种情况

Ann Surg:减肥术后警惕餐后高胰岛素低血糖

Roux-en-Y胃旁路手术(RYGB)是一种改变肠道结构、关闭大部分胃功能的手术。手术将患者的胃分成上下两部分,用于容纳食物的只有原来胃部的1/6-1/10,然后在小胃的切口处开一条“岔路”,接上截取的一段小肠,重新排列小肠的位置,改变食物经过消化道的途径,减缓胃排空速度,缩短小肠,降低吸收,从而达到减肥的目的。 经常有RYGB术后餐后高胰岛素低血糖(PHH)的报道,但目前关于PHH的临床