高血压患者结直肠腺瘤发病的危险因素分析

Analysis of related risk factors for colorectal adenomatous polyps in patients with hypertension

目的探讨高血压患者结直肠腺瘤发生的相关危险因素。方法回顾性分析2013年3月至2014年11月于首都医科大学附属北京友谊医院内镜中心行结肠镜检查的212例高血压患者的临床资料,经病理证实为结直肠腺瘤的47例患者作为观察组,结肠镜结果未见明显异常或经病理证实为非腺瘤性息肉的165例患者作为对照组。收集两组患者的年龄、性别、体重指数、基本信息、个人史、既往史、肠道清洁度等资料,分析高血压患者发生结直肠腺瘤的相关危险因素。结果单因素分析显示,结直肠腺瘤的发生与年龄、饮酒及息肉史相关(P<0.05)。多因素logistic回归分析结果显示,年龄(P=0.001)、饮酒(P=0.001)及肿瘤家族史(P=0.041)是高血压患者发生结直肠腺瘤的独立危险因素。多因素回归模型预测高血压患者结直肠腺瘤的曲线下面积与一致性指数均为0.719,对于高血压患者发生结直肠腺瘤具有一定的预测作用。结论年龄、饮酒及肿瘤家族史为高血压患者发生结直肠腺瘤的独立危险因素,在对高血压患者行结肠镜筛查前,可以综合权衡与腺瘤发生相关的危险因素,筛选出结直肠腺瘤发病的高危人群,以提高结直肠腺瘤的检出率。

Objective To investigate the risk factors of colorectal adenoma in patients with hypertension.Method A total of 212 patients with hypertension admitted at the Endoscopic Center of Beijing Friendship Hospital from March 2013 to November 2014 were analyzed retrospectively.If there were colonoscopic lesions,they were divided into adenoma group and control group according to the pathological results.47 patients pathologically diagnosed as colorectal adenoma were included in observation group,and the remaining 165 subjects had no obvious abnormality in endoscopic findings or pathologically confirmed inflammatory or proliferative polyps were included in control group.Collect patients’age,sex,BMI,basic information,personal history,past history,intestinal cleanliness and other factors,and statistically analyze the risk factors of colorectal adenoma in patients with hypertension.Result 212 patients with hypertension were selected,including 47 patients in the observation group and 165 patients in the control group.The independent sample t test showed age was the risk factor of colorectal adenoma(P<0.05).The chi-square test and continuity correction of chi-square test showed drinking and polyp-growing history were correlative factors of colorectal adenoma(P<0.05).Multivariate logistic regression model analysis showed that age(P=0.001),alcohol drinking(P=0.001)and family history of tumor(P=0.041)were independent risk factors of colorectal adenoma in patients with hypertension.The multivariate regression model predicts colorectal adenoma in hypertensive patients with the area under the curve and the consistency index of both 0.719,which has a certain predictive effect of colorectal adenoma in patients with hypertension.Conclusion Age,drinking and family history of tumor are independent risk factors for colorectal adenoma in patients with hypertension.Before the colonoscopical screening of patients with hypertension,we can comprehensively screen the high-risk population with colorectal adenoma and improve the detection rate of these lesions which may improve the long-term prognosis of the high-risk population.