代谢综合征患者不同心血管疾病发生风险和NLR对结直肠腺瘤复发的影响

The risk of different cardiovascular diseases in patients with metabolic syndrome and the effect of NLR on the recurrence of colorectal adenoma

目的探讨代谢综合征患者结直肠腺瘤复发与心血管疾病发生风险和NLR之间的关系。方法收集2011年1月～2017年7月于我院检查发现患有代谢综合征合并结直肠腺瘤并行内镜下切除的152例患者资料,回顾患者病历,记录并比较相关临床信息。单因素和多因素Cox回归分析腺瘤复发的影响因素、心血管疾病发生风险评分和NLR水平与腺瘤复发的关系。结果心血管疾病发生中高风险、NLR≥2.05、使用降糖药物、合并NAFLD、首次肠镜检查间隔时间>1年的代谢综合征患者其结直肠腺瘤复发的风险明显升高(P<0.05);而长期运动为代谢综合征患者结直肠腺瘤复发的保护因素(P<0.05)。冠心病评分中高风险的代谢综合征患者结直肠腺瘤复发的风险明显增加,且腺瘤复发的风险随着NLR水平的升高而递增。结论代谢综合征患者冠心病发生风险增加和NLR水平升高可协同增加结直肠腺瘤复发的风险。

Objective To investigate the relationship between the recurrence of colorectal adenoma and the risk of cardiovascular disease,NLR in patients with metabolic syndrome.Methods Data from 152 patients with metabolic syndrome complicated with colorectal adenoma and endoscopic resection were collected from Shekou People's Hospital from January 2011 to July 2017.The patient's medical records were reviewed,and relevant clinical information was recorded and compared.Univariate and multivariate Cox regression analysis was used to analyze the influencing factors of adenoma recurrence,and the relationship between NLR levels,cardiovascular disease risk scores and adenoma recurrence.Results The risk of colorectal adenoma recurrence was significantly higher in metabolic syndrome patients with high risk of cardiovascular disease,NLR≥2.05,hypoglycemic drugs,combined with NAFLD,and first colonoscopy interval>1 year(P<0.05).Long-term exercise was a protective factor for the recurrence of colorectal adenoma in patients with metabolic syndrome(P<0.05).The risk of colorectal adenoma recurrence was significantly increased in patients with high-risk metabolic syndrome in coronary heart disease scores,and the risk of adenoma recurrence increased with increasing NLR levels.Conclusion Increased risk of coronary heart disease and elevated NLR levels in patients with metabolic syndrome can synergistically increase the risk of colorectal adenoma recurrence.