편도 수술이나 충수 수술 하고 나면 훗날 어떤 병에 걸리기 쉽나? > 임상 응용 정보

편도 수술이나 충수 수술 하고 나면 훗날 어떤 병에 걸리기 쉽나?

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편도 수술이나 충수 수술 하고 나면
 
훗날 어떤 병에 걸리기 쉽나</TD></TR>
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20세 이전에 편도 수술이나 충수 수술을 하고 나면 
 
40세 이전에 심근 경색 증에 걸릴 위험이 매우 높아진다는 
 
사실이 밝혀졌다 
 
편도선이나 충수는 20세 이전에는 
 
중요한 면역 기능을 발휘하지만 20세를 넘어서면 
 
그 기능이 감소되어 간다는 사실도 간접 증명되었다
 
수술하면 특히 면역 항체 Immunoglobulin A 가 결핍된다
 
해서 지금까지는 다음과 같은 질환이 발생할 확률이 높아진다고 알려져 왔다
 
-죽상동맥경화, 심근 경색
 
-뇌졸중
 
-호치킨스 림프 종양 
 
-소장에 궤양을 일으키는 크론씨 병 
 
-류머티스 관절염 등이다
 
 
그러나 이러한 사실은 아직까지 입증된 바가 없었다
 
 
해서 Sweden 칼로린스카 의대 연구팀은 
 
전 국민을 대상으로 하여
 
20세 이전에 편도선 수술이나 충수 수술을 받은 자들을 
 
24년간 추적 분석하고
 
특히 심근경색 발생 위험이 현저히 증가한다는 사실을 입증해 낸 것이다
 
 
<IMG src="/_dimg/1%20편도vus.bmp">
 
 
<IMG src="/_dimg/2충수.bmp">
 
 
 
<IMG src="/_dimg/3%20그라프.bmp"></TD></TR>
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심근 경색 발생 비교 위험도 44% 증가</TD></TR>
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20세 이전에 편도선 수술이나 충수 수술을 받은 자와
 
이러한 수술을 받지 않은 자를 24년간 추적 분석하여 
 
비교해 본 결과
 
아래 표에서처럼 편도선 수술의 경우 심근 경색 발생 위험이
 44%나 높아진다는 사실이 발견되었다
 
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편도선 수술</TD>
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수술 안 한 자</TD>
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수술 받은 자*</TD></TR>
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대상자 수 </TD>
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135,401 명</TD>
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27,284 명</TD></TR>
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심근 경색 발생 </TD>
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169명</TD>
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47명</TD></TR>
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발생 비교 위험율</TD>
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1</TD>
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1.44</TD></TR>
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*1955년-1970 태어나 20세 이전에 수술 받은 자</TD></TR>
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총 사망 위험율</TD>
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1</TD>
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1.10</TD></TR>
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심장 관련 사망</TD>
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1</TD>
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0.85</TD></TR>
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뇌졸중 </TD>
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1</TD>
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1.30</TD></TR>
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심장관 동맥 수술</TD>
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1</TD>
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1.47</TD></TR></TBODY></TABLE>
 
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충수 수술</TD>
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수술 안 한 자</TD>
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수술 받은 자</TD></TR>
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대상자 수 </TD>
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272,213명</TD>
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54,449 명</TD></TR>
<TR>
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심근 경색 발생 </TD>
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328 명</TD>
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89명</TD></TR>
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발생 비교위험율</TD>
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1</TD>
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1.31</TD></TR>
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*1955년-1970 태어나 20세 이전에 수술 받은 자</TD></TR>
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총 사망 위험율</TD>
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1</TD>
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1.11</TD></TR>
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심장 관련 사망</TD>
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1</TD>
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1.40</TD></TR>
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뇌졸중 </TD>
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 </TD>
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1</TD>
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1.12</TD></TR>
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심장관 동맥 수술</TD>
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1</TD>
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1.47</TD></TR></TBODY></TABLE></TD></TR>
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수술한 후 심근 경색 발생 연령</TD></TR>
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20세 이전에 충수나 편도를 수술 받고 난 후 
 
심근 경색 발작을 일으킨 자들의 평균 연령은 
 
아래 표에서처럼 40세 이전에 발생하고 있다
 
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심근경색 발생 연령 </TD>
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남자</TD>
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여자</TD></TR>
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충수 수술 자 </TD>
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37.9세</TD>
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37.9세</TD></TR>
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편도 수술 자</TD>
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38.8세</TD>
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38.7세</TD></TR>
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20세 이전 편도나 충수 수술이 왜 심장 질환을 유발?</TD></TR>
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심근 경색을 일으키는 주요 원인은 죽상동맥경화다
 
그러나 이는 단순히 지질이 침착해서  일으키는 병태가 아니다
 
 
즉 혈중 지질만 높다 하여 죽상 동맥 경화가 발생하지 않는다
 
 근본적으로 혈관 조직이 염증을 일으키고 있는 상태에서
 
 혈중 지질이 침착하여 죽종을 형성하게 된다
 
이러한 혈관의 염증 상태는 면역 기능이 불충분할 때 발생한다
 
따라서 20 세 이전의 편도나 충수 같은 점막 성 면역 조직은 
 
 심장 혈관의 염증을 억제하는 기능을 수행한다고 볼 수 있다
 
20세가 지나서도 편도나 충수를 수술하지 않은 자는 
 
 이미 20세 이전에 편도나 충수의 면역 기능에 의해
 
 심장 혈관 조직이 튼튼하게 완성되었을 것이라는 것이 
 
 발표자들의 해석이다
 
해서 20세 이전에는 가능하면 편도나 충수 수술은 하지
 
 말아야 한다고 경고하고 있다</TD></TR>
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근거</TD>
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European Heart Journal Advance Access published June 1, 20
Surgical removal of the tonsils and appendix in young people is associated with an increased relative risk of early heart attack 
Imre Janszky1,2*, Kenneth J. Mukamal3, Christina Dalman1, Niklas Hammar4,5,and Staffan Ahnve1;
1Department of Public Health Sciences, Karolinska Institutet, Norrbacka, 6th floor, Karolinska University Hospital, Stockholm SE-171 76, Sweden; 2Faculty of Medicine, Norwegian
University of Science and Technology, Trondheim, Norway; 3Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA; 4Division of
Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; and 5Epidemiology, AstraZeneca Research and Development, So¨derta¨lje, Sweden</TD></TR></TBODY></TABLE>
 
 
 
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