胆囊息肉样病变的自然病程及相关危险因素分析

Polypoid lesions of gallbladder: changes of the natural history and analysis of the related risk factors

目的调查分析某地区胆囊息肉样病变(PLG)的自然病程及相关危险因素对其病程变化的影响。方法统计西南医科大学附属医院2010年3月至2016年1月经超声诊断为PLG并在肝胆外科门诊长期随访的510例患者临床资料,分析PLG直径增长情况以及危险因素。结果510例中单发息肉293例(57.5%),随访15(2~58)个月,300例(58.8%)息肉直径增大2(1~10)mm,年平均增长速度为0.4 mm;196例(38.4%)直径无变化;8例直径减小;6例消失。单因素分析及多因素Logistic回归分析显示,饮酒和睡眠质量差是PLG直径增大的危险因素(P<0.01),饮酒者的PLG直径增大的风险是非饮酒者的2.615倍,睡眠质量差者的息肉增大风险是睡眠质量正常者的2.282倍。结论泸州地区PLG患者的增长速度缓慢,饮酒、睡眠质量差可能是促进胆囊息肉增长的危险因素。

Objective To investigate the effect of polypoid lesions of gallbladder(PLG)and related risk factors of the disease.Methods The clinical data of five hundred and ten patients were retrospectively analyzed,who were diagnosed with PLG by ultrasound in the Affiliated Hospital of Southwest Medical University from March 2010 to January 2016 and followed up in the Department of Hepatobiliary Surgery.Results Among the 510 patients with PLG,293(57.5%)had single polyp,and the follow-up time was 15(2-58)months.The diameter of 300(58.8%)polyps increased by 2(1-10)mm,with an average growth rate of 0.4 mm/year.There was no change in diameter in 196 cases(38.4%),decreased in eight cases and disappeared in six cases.Univariate analysis and multivariate Logistic regression analysis showed that alcohol consumption and poor sleep quality were risk factors for PLG diameter increasing,and the difference was statistically significant(P<0.01).The drinkers were 2.615 times more likely to have an increased PLG diameter than that of non-drinkers.The risk of increasing polyps of poor sleeping subjects was 2.282 times higher than that of subjects with normal sleep.Conclusions The growth rate of PLG patients in Luzhou region is slow.Drinking alcohol and poor sleeping quality may be risk factors for gallbladder polyp growth.