代谢相关性因素与结直肠癌的临床研究

发布时间：2018-12-07 07:59

【摘要】：目的:通过1:1病例-对照研究的方法,检测结直肠癌患者的代谢相关性指标(体重指数、高血糖、血脂异常、高血压、高尿酸血症、非酒精性脂肪肝、冠心病、D-二聚体、血清总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白)与结直肠腺瘤、健康体检者的差异,来探讨研究各代谢指标与结直肠癌的相关性,从而用来协助结直肠癌的早期筛查。方法:选取2014.10-2016.1在延安大学附属医院行相关检查并确诊为结直肠癌的患者75例为病例组,同期的结直肠腺瘤患者75例及正常体检人群75例为对照组。根据生化检查、影像学检查及既往病史等资料,收集代谢相关性指标及患者的一般情况,分析各代谢指标与结直肠癌的相关性。结果:1.结直肠癌组与对照组(结直肠腺瘤组、正常对照组)的年龄、性别比较无统计学差异,而结直肠癌组患者的发病年龄集中于50~75岁之间。2.结直肠癌组的BMI、高尿酸血症、高血压、非酒精性脂肪肝、冠心病的患病率与对照组相比,差异无统计学意义。3.结直肠癌组的高血糖及血脂异常的患病率要高于对照组,差异有统计学意义。4.与对照组相比,结直肠癌组的D-二聚体、TG水平较高,而TC、LDL-C、HDL-C较低,差异有统计学意义。5.经条件Logistic回归分析发现高血糖、血脂异常及D-二聚体水平与结直肠癌有相关性,是其独立危险因素。结论:结直肠癌是与代谢紊乱有关的疾病,高血糖、血脂异常、D-二聚体水平是其独立危险因素。对平均风险人群行代谢相关指标的筛查,并结合结直肠镜检查,可以提高临床结直肠癌的检出率,从而协助我们早期预防、诊断及治疗结直肠癌。
[Abstract]:Objective: to detect metabolic correlation indexes (body mass index, hyperglycemia, dyslipidemia, hypertension, hyperuricemia, non-alcoholic fatty liver, coronary heart disease) in colorectal cancer patients by 1:1 case-control study. In order to study the correlation between the metabolic indexes and colorectal adenoma, the differences of D-dimer, serum total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein (HDL) and colorectal adenoma were studied. This is used to facilitate early screening for colorectal cancer. Methods: 75 patients with colorectal cancer were selected as the case group, 75 patients with colorectal adenoma and 75 healthy persons as control group. According to the data of biochemical examination, imaging examination and past medical history, the correlation index of metabolism and the general situation of patients were collected, and the correlation between each metabolic index and colorectal cancer was analyzed. Results: 1. There was no significant difference in age and sex between colorectal cancer group and control group (colorectal adenoma group, normal control group), whereas the onset age of colorectal cancer patients was between 50 and 75 years old. 2. 2. The prevalence of BMI, hyperuricemia, hypertension, non-alcoholic fatty liver and coronary heart disease in colorectal cancer group was not significantly different from that in control group. The prevalence of hyperglycemia and dyslipidemia in colorectal cancer group was significantly higher than that in control group. Compared with the control group, the level of TG in colorectal cancer group was higher than that in control group, but the level of TC,LDL-C,HDL-C was lower (P < 0.05). Conditional Logistic regression analysis showed that hyperglycemia, dyslipidemia and D-dimer levels were associated with colorectal cancer and were independent risk factors. Conclusion: colorectal cancer is related to metabolic disorder, hyperglycemia, dyslipidemia and D-dimer level are independent risk factors. Screening of metabolic related indexes in the average risk population, combined with colonoscopy, can improve the detection rate of clinical colorectal cancer and help us to prevent, diagnose and treat colorectal cancer in the early stage.
【学位授予单位】：延安大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.34

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