代谢综合征因素与大肠肿瘤的关系

The relationship between colorectal tumors and metabolic syndrome

目的研究代谢综合征因素如血糖、甘油三酯、胆固醇及高血压与大肠肿瘤发病的关系。方法回顾分析2002年1月至2006年6月住院并接受结肠镜检查308名患者的临床资料。结果 308例患者中197例患者(64.0%)检出大肠息肉,包括炎性息肉38例(12.3%),瘤性息肉159例(51.6%),其中进展期息病变为78例(25.3%)。分别以患者空腹血糖、甘油三酯、胆固醇、收缩压水平分组,经年龄校正后对上四分之一区组与下四分之一区组息肉检出情况进行比较,结果甘油三酯及血压上四分之一区息肉检出率(75.3%,80.O%),瘤性息肉检出率(63.6%,66.2%),进展期息病变检出率(36.4%,30.8%),均显著高于下四分之一区检出率(除血压分区进展期息病变检出率比较 P<0.10,余均 P<0.05。高甘油三酯对大肠息肉及瘤性息肉 OR 分别为2.55,2.21,高血压对大肠息肉及瘤性息肉 OR 分别为2.30,2.16)。血糖及胆固醇分区息肉检出率及瘤性息肉检出率相比差异无统计学意义(P>0.05)。结论高甘油三酯及高血压可能为大肠肿瘤发病的危险因素,该类患者进展期息病变检出率较高,需进行大肠肿瘤的筛查。

Objective To study the relationship between colonretal tumors and metabolic syndrome. Methods Retrospectively analyze the clinic manifestation of inpatients including serum glucose, serum triglyceride, serum cholesterin and blood pressure. 308 patients who had accepted colonoscopy were recruited in the study from 2002 to 2006. Results 197 patients （ 64. 0% ） with colonretal polyps, 159 patients （51.6%） with tumour polyps of adenoma or cancer and 78 patient（25.3% ）with advanced lesion were detected. According to the serum glucose, triglyceride, cholesterin and level of blood pressure, the cases were divided into four groups respectively. The ratios of polyps in the high quarter and the low quarter of each group were compared after standardized by ages. The polyps＇ ratios （ 75.3%, 80. 0% ）, tumour polyps＇ ratios （63.6% ,66. 2% ） and advanced lesion＇ ratios （ 36. 4% , 30. 8% ） in the higher triglyceride and hypertension quarters were higher than that in the low quarters. （ In the comparison between the advance polyps＇ ratios in blood pressure group P 〈0. 10, and in the other comparisons P 〈0. 05. ） ,The polyps＇ratios and tumour polyps＇ratios between the high and low quarters had no significant difference in the glucose and cholesterin groups （ P 〉 0. 05 ）. Conclusion High serum triglyceride and hypertension are risk factors for the incidence of colonretal tumors. The patients with these risk factors should accept colonoscopy to exclude colorectal tumors.