双镜联合保胆取石术前后血清瘦素变化与结石复发的相关性研究

Study on the correlation between the changes of Leptin and the recurrence of calculus after double lens combination in minimally invasive gallbladder-preserving cholecystolithotomy

目的探究血清瘦素变化与保胆取石术后结石复发的相关性。方法回顾性分析43例于该院住院并接受双镜联合保胆取石术的患者的临床资料,以体重指数(BMI)=24 kg/m2为标准,分为超重组(BMI≥24 kg/m2,n=21)和正常体重组(BMI<24 kg/m2,n=22);统计分析两组患者的一般情况、手术前后及术后药物干预后血清瘦素水平、手术前后血脂[血清总胆固醇(TC)、三酰甘油(TAG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)等]指标、术后结石复发情况。结果术前:超重组TAG和LDL高于正常体重组,差异有统计学意义(P<0.05);超重组血清瘦素高于正常体重组,差异有统计学意义(P<0.05)。术后:超重组TAG和LDL水平高于正常体重组,差异有统计学意义(P<0.05);超重组血清瘦素高于正常体重组,但差异无统计学意义(P>0.05)。超重组术前HDL、TC、TAG和LDL等血脂水平与术后比较,差异无统计学意义(P>0.05);术后血清瘦素水平明显低于术前,差异有统计学意义(P<0.05)。两组患者术后口服牛磺熊去氧胆酸胶囊6个月,超重组血清瘦素高于正常体重组,但差异无统计学意义(P>0.05);术后随访期间,超重组结石复发1例,正常体重组无结石复发病例,差异无统计学意义(P>0.05)。结论血清瘦素在双镜联合保胆取石术后明显降低,术后口服牛磺熊去氧胆酸胶囊6个月亦无明显增高,术后结石复发病例少,血清瘦素可能作为保胆取石术后结石复发的相关检测指标,对于术后结石复发的诊治具有重要意义。

Objective To detect the correlation between the changes of Leptin and the recurrence of calculus after double lens combination in minimally invasive gallbladder-preserving cholecystolithotomy. Methods The clinical data of 43 patients who underwent double lens combination in minimally invasive gallbladder-preserving cholecystolithotomy were retrospectively analyed. With body mass index (BMI) = 24 kg/m2 as the standard, they were divided into overweight group (BMI ≥ 24 kg/m2, n = 21) and normal weight group (BMI < 24 kg/m2, n = 22). The general situation, serum Leptin level and serum lipid indexes [total cholesterol (TC), triacylglycerol (TAG), high density lipoprotein (HDL) and low density lipoprotein (LDL)] before and after surgery were detected in two groups, and the postoperative stone recurrence was recorded after 6 months of follow-up. And the experimental results were statistically analyzed. Results Pre-operation: TAG and LDL of overweight group were significantly higher than those in normal weight group (P < 0.05);The serum Leptin of overweight group was significantly higher than that of normal weight group (P < 0.05). Post operation: the levels of TAG and LDL in overweight group were significantly higher than those of normal body weight group (P < 0.05);The serum Leptin in overweight group was higher than that of normal weight group, but the difference was not statistically significant (P > 0.05). There were no significantly differences in the levels of HDL, TC, TAG and LDL before and after operation in overweight group (P > 0.05). The serum Leptin level after surgery was significantly lower than that before surgery (P < 0.05). After 6 months of taurosulu deoxycholic acid, the serum Leptin in overweight group was not statistically higher than that in normal weight group (P > 0.05). During postoperative follow-up, there was 1 case of recurrence of calculi in overweight group, while no case of recurrence of calculi in the normal weight group (P > 0.05). Conclusion Serum leptin decreased significantly after double lens combination in minimally invasive gallbladder-preserving cholecystolithotomy, but not increase significantly after 6 months of taurosulu deoxycholic acid, and there were few postoperative calculus recurrence cases. Serum Leptin may be used as a detection index for the recurrence of calculus after gallbladder-preserving cholecystolithotomy.