结直肠息肉与幽门螺杆菌感染及血脂水平的相关性研究

Correlation of colorectal polyps with Helicobacter pylori infection and blood lipid levels

目的探讨结直肠息肉发生与幽门螺杆菌(Helicobacter pylori,H.pylori)感染及血脂水平升高的相关性,为通过检测H.pylori和血脂水平对结直肠息肉的早期诊断提供理论依据。方法选取广州医科大学附属第三医院2020年1月1日至2020年6月30日行肠镜检查的患者250例,根据检查结果,185例为观察组(结直肠息肉),65例为对照组(结直肠无明显异常),所有患者均完成呼气试验及血脂水平检测。回顾性分析结直肠息肉的大小、数量、病理分型、山田分型、发生部位与H.pylori感染及血脂水平异常的关系。结果观察组H.pylori感染率高于对照组(P<0.01)。结直肠息肉的大小(≥10 mm)、数量(多发)、病理分型(腺瘤性)与H.pylori感染呈正相关(P<0.05)。结直肠息肉山田分型及发生部位与H.pylori感染无相关(P>0.05)。观察组患者的LDL-C、TC、Apo B、Lp(a)水平均高于对照组(P<0.05),其中观察组H.pylori阳性患者的LDL-C、TC、Apo B水平均高于H.pylori阴性患者(P<0.05)。在H.pylori感染的情况下,血脂水平升高者的结直肠息肉发生率高于血脂水平正常者(P<0.01)。结论结直肠息肉的发生与H.pylori感染及血脂水平升高呈正相关。在H.pylori感染的情况下,血脂水平升高的患者结直肠息肉发生率高,结直肠息肉患者息肉体积大、数量多、病理分型为腺瘤性息肉者H.pylori感染率更高。H.pylori感染、高TC、高LDL-C、高Apo B是结直肠息肉发生的危险因素。对于H.pylori感染合并血脂水平升高的患者,临床上应积极采取措施进行干预。

Objective To investigate the correlation between the occurrence of colorectal polyps and Helicobacter pylori(H.pylori)infection and blood lipid levels,and to provide a theoretical basis for the early diagnosis of colorectal polyps by detecting H.pylori and blood lipid levels.Methods 250 patients who underwent colonoscopy from Jan.1st,2020 to Jun.30,2020 in the Third Affiliated Hospital of Guangzhou Medical University were selected,and according to the examination results,185 cases were in the observation group(colorectal polyps)and 65 cases were in the control group(no significant abnormalities in the colorectum),and all patients completed the breath test and blood lipid levels detection.The size,number,pathological typing,Yamada typing,and site of occurrence of colorectal polyps were retrospectively analyzed in relation to H.pylori infection and abnormal blood lipid levels.Results The rate of H.pylori infection in the observation group was higher than that in the control group(P<0.01).The size(≥10 mm),number(multiple),and pathological typing(adenomatous)of colorectal polyps were positively correlated with H.pylori infection(P<0.05).Colorectal polyp Yamada typing and site of occurrence were not significantly correlated with H.pylori infection(P>0.05).The levels of LDL-C,TC,Apo B and Lp(a)were higher in the observation group than those in the control group(P<0.05),in which the levels of LDL-C,TC and Apo B were higher in H.pylori-positive patients than those in H.pylori-negative patients in the observation group(P<0.05).In the case of H.pylori infection,the incidence of colorectal polyps was higher in those with elevated lipids than in those with normal lipid levels(P<0.01).Conclusion The incidence of colorectal polyps is positively correlated with H.pylori infection and elevated blood lipid levels,and the incidence of colorectal polyps is higher in patients with elevated blood lipid levels in the presence of H.pylori infection,and the incidence of H.pylori infection is higher in patients with colorectal polyps with large polyp size,high number of polyps,and pathological typing of adenomatous polyps.For patients with H.pylori-positive combined with elevated blood lipid levels,clinical interventions should be actively taken.