老年胃息肉病人合并结直肠息肉发病危险因素分析

Analysis of risk factors of the incidence of colorectal polyps in elderly patients with gastric polyps

目的 分析老年胃息肉合并结直肠息肉发病的危险因素,为临床早期预防和干预提供一定的依据。 方法 回顾性分析2014年8月至2017年10月在我院行内镜下黏膜切除术的188例老年胃息肉病人的临床资料,根据肠镜检查结果将其分为对照组(单纯性胃息肉)70例和病例组(胃息肉合并结直肠息肉)118例。记录病人的一般资料及病史情况,比较2组病人的发病相关因素。采用多因素Logistic回归分析老年胃息肉合并结直肠息肉的危险因素。 结果 与对照组相比,病例组男性,有冠心病、脂肪肝、胃肠息肉家族史的病人比例明显升高,差异有统计学意义(P<0.05)。2组病人在年龄、吸烟、饮酒、幽门螺杆菌(Helicobacterpylori,HP)感染率、病灶大小、糖尿病、高脂血症、高血压、胆囊炎/胆囊结石方面的差异无统计学意义(P>0.05)。多因素Logistic回归分析显示男性(OR=3.168,P=0.003,95%CI:1.475~6.802)、胃肠息肉家族史(OR=2.637,P=0.005,95%CI:1.338~5.196)为胃息肉合并结直肠息肉的危险因素,饮酒(OR=0.302,P=0.013,95%CI:0.118~0.773)可能为保护因素。 结论 对于存在冠心病、脂肪肝、胃肠息肉家族史的老年男性胃息肉病人,需常规进行胃肠镜筛查,并早期行内镜下治疗,是预防胃肠腺瘤进展的主要措施。

Objective To analyze the risk factors of the incidence of colorectal polyps in the elderly patients with gastric polyps, and to provide advice for early clinical prevention and intervention. Methods Retrospective analysis of clinical data of 188 elderly patients with gastric polyps who underwent endoscopic mucosal resection in our hospital from August 2014 to October 2018 was carried out. All the patients were divided into control group (70 cases) and case group (118 cases) according to the coloscopy results. The patients. general information and medical history were recorded and compared between the two groups. Risk factors of gastric polyps complicated with colorectal polyps were analyzed by multivariate Logistic regression analysis. Results Compared with the control group, the proportion of male, and the incidence rates of coronary heart disease, fatty liver, family history of gastrointestinal polyps were significantly higher in the case group, and the differences were statistically significant (P< 0. 05). There were no differences in age, smoking, alcohol consumption, Helicobacter pylori infection rate, lesion size, diabetes, hyperlipidemia, hypertension and cholecystitis/ cholelithiasis between the two groups. Multivariate Logistic regression analysis showed that male (OR = 3. 168,P = 0. 003,95% CI: 1. 475-6. 802), family history of gastrointestinal polyps (OR =2. 637,P =0. 005,95%CI:1. 338-5. 196) were risk factors for gastric polyps complicated with colorectal polyps, while drinking (OR = 0. 302,P = 0. 013,95% CI:0. 118-0. 773) was a protective factor. Conclusions Colonoscopy screening and endoscopic therapy in the elderly male with gastric polyps complicated with coronary heart disease and fatty liver may be the main method to prevent the progression of gastric and colorectal polyps.