血脂及脂质过氧化与大肠腺瘤的相关性

The relationship between serum lipids,lipid peroxidatio and colorectal adenomas

目的探讨血脂及脂质过氧化与大肠腺瘤恶变的关系。方法病例来源于2007年5月～2008年3月在武汉大学人民医院进行结肠镜检查诊断为大肠腺瘤的98例患者，对照病例为全结肠镜检查未发现病变的40例患者，结肠镜检前取静脉血检测血脂及血浆脂质过氧化产物丙二醛（MDA）。结果大肠腺瘤组血浆胆固醇和MDA高于对照组，而血浆高密度脂蛋白胆同醇则低于对照组，差异有显著性（P〈0．05）；远侧大肠腺瘤组和绒毛状腺瘤组血浆胆同醇和MDA分别高于近侧大肠腺瘤组和混合＋管状腺瘤组，差异有显著性（P〈0．05）；大肠腺瘤组和对照组各组内男女间血脂和血浆MDA比较差异无显著性（P〉0．05）。结论血浆胆固醇和丙二醛水平增高及血浆高密度脂蛋白胆同醇水平降低是结肠腺瘤发生的潜在危险因素，而且血浆胆同醇和丙二醛异常与大肠腺瘤的发生部位组织成分存存相关性。

Objective To evaluate the relationship between serum lipids, lipid peroxidatio and colorectal adenomas. Methods Analysis was based on data of 98 subjects with histologically confirmed adenoma and 40 adenoma-free control subjects, all of them had colonoseopy. The subjects were divided into two groups： those with no adenoma and those with adenoma. According to subsite of adenomas, the subjects with adenoma were divided into the group of distal adenoma and the group of proximal adenoma. According to histology of adenomas, the subjects with adenoma were divided into the group of villiform adenoma, the group of tubular and tubulovillous adenoma. Serum lipids and MDA were detected. Results Plasma total cholesterol and MDA levels in the group of adenomas were significantly higher than that in control group, but plasma HDL-eholesterol level was lower in the group of adenomas （P 〈 0.05 ）. Plasma total cholesterol and MDA levels were positively related with distal and villiform adenomas （P 〈 0.05 ）. Conclusion The findings suggest that altered lipid metabolism may be associated with colorectal adenomas.