结直肠息肉、代谢综合征及幽门螺杆菌感染的相关性研究

发布时间：2018-04-23 11:43

本文选题：结直肠息肉 + 代谢综合征　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:结直肠息肉是消化系统常见疾病,现已明确其为结直肠癌前病变。幽门螺杆菌感染也是消化系统常见疾病,其为胃、十二指肠炎症及溃疡的病因,并且与胃癌具有明确的相关性。代谢综合征为一种高发的代谢紊乱综合症候群,已明确其为心脑血管疾病的危险因素。许多临床研究及荟萃分析指出这三种高发疾病可能存在着一定的相关性,本研究正是围绕这三种疾病是否存在相关性以及存在怎样的相关性而展开,旨在为相关领域的研究提供新的证据,为相关科室的临床工作提供一定的参考。方法:本研究对符合纳入标准的213例患者的相关临床资料进行记录、整理,并将其分成不同的组分进行比较。首先将其分为结直肠息肉组与对照组、腺瘤性息肉组与非腺瘤性息肉组、高危腺瘤组与非高危腺瘤组,左半结肠组、右半结肠组及全结肠组,分别对各组的年龄、性别、代谢相关疾病患病情况、代谢综合征患病率及代谢综合征各组分进行比较以明确结直肠息肉与代谢综合征之间是否具有相关性,具有怎样的相关性。接下来再将以上分组的幽门螺杆菌阳性率进行比较以明确结直肠息肉与幽门螺杆菌感染之间是具有相关性,具有怎样的相关性。最后将213例患者重新分为幽门螺杆菌阳性组与幽门螺杆菌阴性组,将两组的代谢相关疾病患病情况、代谢综合征患病率及代谢综合征各组分进行比较以明确幽门螺杆菌感染与代谢综合征之间是否具有相关性,具有怎样的相关性。结果:1、结直肠息肉组患者平均年龄57.20±10.92,高于对照组患者平均年龄52.72±13.17,差异具有统计学意义(P=0.008)。2、结直肠息肉组患者糖尿病患病率高于对照组,χ2=7.260,差异具有统计学意义(P=0.007)。3、结直肠息肉组患者代谢综合征患病率高于对照组,χ2=6.640,差异具有统计学意义(P=0.010)。4、结直肠息肉组TG水平1.60(1.12,2.48),高于对照组1.31(0.96,1.91),差异具有统计学意义(P=0.003)。5、对结直肠息肉患者进行非条件Logistic回归检验,结果提示TG水平及糖尿病患病情况与结直肠息肉的发生之间存在正相关,OR值分别为1.290和3.205,P0.05。6、高危腺瘤组患者平均年龄60.63±9.47,高于对照组患者平均年龄53.32±12.76,差异具有统计学意义(P=0.005)。7、腺瘤性息肉组患者HP阳性率高于对照组,χ2=4.254,差异具有统计学意义(P=0.039)。8、高危腺瘤组与非高危腺瘤组,左半结肠组、右半结肠组及全结肠组的HP阳性率差异无统计学意义。9、HP阳性组与HP阴性组的代谢情况差异均无统计学意义。结论:(1)代谢综合征为结直肠息肉的危险因素,当这些患者出现相应消化系统症状时,应考虑行结直肠镜检查。(2)代谢综合征组分中的甘油三酯水平及是否患有糖尿病为结直肠息肉的危险因素,结直肠息肉高危人群应积极控制代谢综合征相关指标,尤其是甘油三脂及血糖水平。(3)高龄者发生结直肠息肉以及高危腺瘤的可能性大,对于高龄人群,尤其是合并其他危险因素者可将结直肠镜检查作为体检筛查项目之一。(4)幽门螺杆菌感染者发生腺瘤性息肉的可能性大,对于HP阳性患者,尤其是合并其他危险因素者,可考虑行幽门螺杆菌根除治疗。(5)幽门螺杆菌与代谢综合征之间无明显相关性。
[Abstract]:Objective: colorectal polyps are common diseases of the digestive system and are now clearly defined as precancerous lesions. Helicobacter pylori infection is also a common disease of the digestive system. It is the cause of gastric, duodenal inflammation and ulcers, and has a clear correlation with gastric cancer. Metabolic syndrome is a high incidence of metabolic disorder syndrome, which has been clearly defined. It is a risk factor for cardiovascular and cerebrovascular diseases. Many clinical and meta-analysis points out that there may be a certain correlation between these three high incidence diseases. This study is based on the relevance and relevance of the three diseases. Clinical work provides some reference. Methods: the clinical data of 213 patients with the inclusion criteria were recorded, arranged and divided into different components. First, they were divided into colorectal polyp group and control group, adenomatous polyp group and non adenomatous polyp group, high risk adenoma group and non high risk adenoma group. In the left semicolon group, the right hemicolon group and the whole colon group, the age, sex, metabolic related diseases, metabolic syndrome and metabolic syndrome were compared to determine whether the correlation between colorectal polyps and metabolic syndrome was related. The positive rate of Helicobacter pylori was compared to determine the correlation between colorectal polyps and Helicobacter pylori infection. In the end, 213 patients were redivided into Helicobacter pylori positive group and Helicobacter pylori negative group, and the prevalence of metabolic syndrome, metabolic syndrome and metabolic syndrome in the two groups were analyzed. The results were as follows: 1, the average age of the patients in the colorectal polyp group was 57.20 + 10.92, higher than the average age of the control group of 52.72 + 13.17, with a statistically significant difference (P=0.008).2, and the sugar of the colorectal polyp group. The prevalence rate of urinary disease was higher than that of the control group, the difference was statistically significant (P=0.007).3. The prevalence rate of metabolic syndrome in the colorectal polyp group was higher than that of the control group, and the difference was statistically significant (P=0.010).4, the TG level of colorectal polyp group was 1.60 (1.12,2.48), higher than that of the control group (1.31 (0.96,1.91) (0.96,1.91), and the difference was statistically significant (P=0.0) (P=0.0) (P=0.0). (P=0.0), the difference has statistical significance (P=0.0). 03).5, the unconditional Logistic regression test for colorectal polyps showed that there was a positive correlation between the level of TG and the incidence of diabetes and the occurrence of colorectal polyps. The OR values were 1.290 and 3.205, respectively, P0.05.6, and the average age of the high risk adenoma group was 60.63 + 9.47, higher than the average age of the control group, which was 53.32 + 12.76. Statistical significance (P=0.005).7, the positive rate of HP in the adenomatous polyp group was higher than that of the control group, the difference was statistically significant (P=0.039).8, the high risk adenoma group and non high risk adenoma group, the HP positive rate of the left semicolon group, the right hemicolon group and the whole colon group had no statistical significance.9, the metabolic difference between the HP positive group and the HP negative group was different. No statistical significance. Conclusions: (1) metabolic syndrome is a risk factor for colorectal polyps. When these patients have the corresponding digestive system symptoms, a colorectal mirror should be considered. (2) the level of triglycerides in the metabolic syndrome and the risk factors for diabetes as a colorectal polyp, and the high risk population of colorectal polyps should be considered. Positive control of metabolic syndrome related indicators, especially glycerol three fat and blood sugar levels. (3) the age of older persons with colorectal polyps and high risk of adenoma is more likely. For older people, especially those with other risk factors, direct colonoscopy can be considered as one of the screening items. (4) the incidence of adenoma and rest in Helicobacter pylori infection The possibility of meat is large, and for HP positive patients, especially those with other risk factors, Helicobacter pylori eradication therapy can be considered. (5) there is no significant correlation between Helicobacter pylori and metabolic syndrome.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R57;R589

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