胆固醇息肉形成的影响因素分析

Analysis of the factors influencing the formation of cholesterol polyps

目的探讨胆固醇胆囊息肉形成的高危因素。方法将广州市第一人民医院住院的219例接受腹腔镜胆囊切除的患者按照术后胆囊病理结果分为胆固醇息肉组(162例)和非胆固醇息肉组(57例)。对所有研究对象的年龄、性别、血脂水平、肝功、超敏C反应蛋白、CA199、癌胚抗原(CEA)、胆囊结石病史、糖尿病病史、肝硬化病史进行数据收集及统计学处理。结果经非参数检验方法Mann-Whitney U分析结果显示:1.脂代谢相关指标在胆固醇息肉组和非胆固醇息肉组间比较差异有统计学意义;2.总胆固醇指标在胆固醇息肉组高于非胆固醇息肉组,且高于参考值范围;3.胆固醇息肉组和非胆固醇息肉组比较部分脂代谢指标有统计学意义,但均在参考值范围内。胆固醇息肉形成的Logistic回归分析:得到的Logistic模型差异有统计学意义,χ^(2)=179.14,P<0.001。模型纳入的8个自变量中,总胆固醇每增加一个单位,发生胆固醇息肉的风险相比于非胆固醇息肉组将增加38.2倍(P<0.05)。结论总胆固醇是胆囊胆固醇息肉形成的高危因素。

Objective To investigate the risk factors of cholesterol polyps formation.Methods The 219 patients who underwent laparoscopic cholecystectomy in Guangzhou First People’s Hospital were divided into cholesterol polyps group(162 cases)and non-cholesterol polyp group(57 cases)according to postoperative gallbladder pathological results.The age,gender,blood lipids levels,liver function,high-sensitivity C-reactive protein,CA199,carcinoembryonic antigen(CEA),history of gallstones,diabetes,and liver cirrhosis of all patients were collected and statistically processed.Results Mann-Whitney U analysis by nonparametric test method showed that the lipid metabolism-related indexes were significantly different between the cholesterol polyps group and the non-cholesterol polyp group.The total cholesterol indexes in the cholesterol polyps group were higher than those in the non-cholesterol polyp group,and higher than the reference range.The cholesterol polyps group and the noncholesterol polyp group had statistical significance in some lipid metabolism indexes,but they were all in the normal range.Logistic regression analysis of cholesterol polyps formation showed the obtained Logistic model was statistically significant,χ^(2)=179.14,P<0.001.Among the 8 independent variables included in the model,total cholesterol was statistically significant.For each unit increased in total cholesterol,the risk of developing cholesterol polyps increased by 38.2 times compared with the non-cholesterol polyp group.Conclusions Total cholesterol is a high risk factor for the formation of cholesterol gallbladder polyps.