华北油田地区职工体检结直肠腺瘤息肉发生的危险因素调查

Risk factors of colorectal adenomatous polyps among workers in Huabei Oilfield

目的分析华北油田地区职工体检结直肠腺瘤息肉发生的危险因素。方法选择2017年1月~2018年12月在我院体检结肠镜的华北油田地区职工2 000例,研究华北油田地区职工结直肠腺瘤性息肉的发病率,并根据检查结果分为腺瘤性息肉组与健康对照组,比较两组受试者一般资料,分析发生结直肠腺瘤息肉的危险因素。结果 2 000例华北油田地区职工中有548例结直肠息肉者,其中腺瘤性息肉312例,检出率15.60%(312/2 000),共检出431枚腺瘤。其中134例单发腺瘤,297例多发腺瘤。经病理检查存在以下类型,管状腺瘤343枚,管状绒毛状腺瘤78枚,锯齿状腺瘤8枚,绒毛状腺瘤2枚。腺瘤直径超过10 mm 19枚,伴高级别上皮内瘤变8枚,高危腺瘤者31枚。腺瘤位置:右半结肠190枚(44.78%),左半结肠168枚(38.98%),直肠73枚(16.94%)。腺瘤性息肉组患者男性、年龄、BMI、有吸烟史、饮酒史、喜食肥肉、动物内脏、油炸食品、不喜低纤维素、直系亲属患大肠癌或大肠息肉或有大肠息肉病史、甘油三酯、总胆固醇、Hp阳性率均高于对照组(P<0.05)。年龄、不良习惯(喜食肥肉、动物内脏、食品、不喜低纤维素)、家族遗传史(直系亲属患大肠癌或大肠息肉或有家族性结肠息肉病)、血脂(甘油三酯、总胆固醇)、Hp阳性是发生直肠腺瘤性息肉危险因素(P<0.05)。结论年龄≥51岁、不良习惯(喜食肥肉、动物内脏、油炸食品、不喜低纤维素)、直系亲属患消化道肿瘤病史、血脂(甘油三酯、总胆固醇)、Hp阳性是华北油田地区职工发生直肠腺瘤性息肉危险因素。

Objective To investigate the risk factors of colorectal adenomatous polyps among workers in Huabei Oilfield region. Methods A total of 2 000 workers in Huabei Oilfield region underwent colonoscopy in our hospital from January 2017 to December 2018 were enrolled, and divided into two groups according to the examination results, which were adenomatous polyp group and control group. The clinical data were compared between groups, then the risk factors of colorectal adnomatous polyps were analyzed. Results There were 548 cases of colorectal polyps in 2 000 workers in Huabei Oilfield, 312 of them were adenomatous polyps, the detection rate was 15.60%(312/2 000), and 431 adenomas were found. There were 134 cases of single adenoma and 297 cases of multiple adenoma. There were 343 tubular adenomas, 78 tubular villous adenomas, 8 serrated adenomas and 2 villous adenomas. There were 19 adenomas with a diameter of more than 10 mm and 8 with high grade intraepithelial neoplasia. There were 31 high-risk adenomas. The location of adenomas: 190(44.78%) in the right colon, 168(38.98%) in the left colon and 73(16.94%) in the rectum. The positive rates of male, age, BMI, smoking history, drinking history, eating fat, animal viscera, fried food, not liking low cellulose, colorectal cancer or polyp or polyp history, triglyceride, total cholesterol and Hp in the adenomatous polyp group were higher than those in the control group(P<0.05). Age, bad habits(like eating fat, animal viscera, food, not like low cellulose), family genetic history(colorectal cancer or polyposis or familial polyposis in the immediate family), blood lipid(triglyceride, total cholesterol), Hp positive were the risk factors for colorectal adenomatous polyposis(P<0.05). Conclusion Age≥51, bad habits(preference for fat, animal viscera, fried food, aversion to low cellulose), direct family members with gastrointestinal tumor history, blood lipid(triglycerides, total cholesterol), and Hp positive are risk factors for the development of colorectal adenomatous polyps among workers in Huabei Oilfield.