胆囊息肉样病变影响因素研究及病例转归分析

Factors affecting polypoid lesion of gallbladder and case outcome analysis

目的探讨胆囊息肉样病变发生以及转归结局的影响因素。方法随机选取全椒县人民医院的胆囊息肉样病变住院治疗患者作为病例组,以性别相同、年龄±3岁为原则按1∶1比例在医院住院治疗中心选择同期住院治疗的非胆囊息肉样病变患者作为对照组进行研究,内容包括个人基本情况、吸烟及饮酒情况、既往史等,采用单、多因素分析胆囊息肉样病变发生及转归影响因素。结果本研究共收入胆囊息肉样病变和非胆囊息肉样病变病例各1371例,病例组年龄平均(57.69±6.89)岁,对照组平均年龄(57.75±7.26)岁,男女比例均为1∶0.68,2组病例年龄、性别差异均无统计学意义(t=0.593、χ^(2)=0.00,均P>0.05),2组病例的婚姻状况、文化程度及家庭月均收入等情况差异均无统计学意义(P>0.05)。1371例胆囊息肉样病变患者中预后良好组共852例,平均年龄(53.47±6.84)岁,预后不良组共519例,平均年龄(64.62±7.18),2组年龄差异有统计学意义(P<0.01)。多因素logistic回归分析结果显示汉族(OR=1.925)、超重及肥胖(OR=1.235)、高血压(OR=2.614)、糖尿病(OR=1.551)、胆囊结石(OR=1.473)、胆囊炎史(OR=1.519)、乙肝核心抗原(anti-HBc)阳性(OR=2.821)为影响胆囊息肉样病变的独立危险因素。年龄(OR=1.711)、男性(OR=1.474)、超重及肥胖(OR=1.220)、糖尿病(OR=1.560)、血脂异常(OR=2.620)、anti-HBc阳性(OR=3.001)为影响胆囊息肉样病变患者疾病转归的独立危险因素。结论胆囊息肉样病变受民族、BMI、高血压、糖尿病、anti-HBc影响,且不同特征的患者转归存在显著差异。

Objective To investigate the factors affecting the occurrence and outcome of polypoid lesion of gallbladder.Methods The patients with polypoid lesion of gallbladder hospitalized in Quanjiao County People's Hospital were randomly selected as the case group.The patients without polypoid lesion of gallbladder who were hospitalized in the hospital treatment center at the same time were selected as the control group according to the principle of the same sex and age±3 years old.The questionnaire survey included personal basic information,smoking and drinking,history,etc.Univariate and multivariate analysis methods were used to analyze the factors affecting the occurrence and outcome of polypoid lesion of gallbladder.Results There were 1371 cases in the case group and the control group,respectively,with an average age of(57.69±6.89)years in the case group and(57.75±7.26)years in the control group.The ratio of male to female in both groups was 1:0.68.There were no significant differences in age and gender between the two groups(t=0.593,χ^(2)=0.00,both P>0.05).There were no significant differences in marital status,education level,and average monthly family income between the two groups(all P>0.05).Among 1371 patients with polypoid lesion of gallbladder,852 patients had a good prognosis,with an average age of(53.47±6.84)years,and 519 patients had a poor prognosis,with an average age of(64.62±7.18)years.There was a statistically significant difference in age between the two groups(P<0.01).Multivariate logistic regression analysis showed that Han nationality(OR=1.925),overweight and obesity(OR=1.235),hypertension(OR=2.614),diabetes(OR=1.551),gallstone(OR=1.473),history of cholecystitis(OR=1.519),and anti-HBc positive(OR=2.821)were independent risk factors for polypoid lesion of gallbladder.Age(OR=1.711),male(OR=1.474),overweight and obesity(OR=1.220),diabetes(OR=1.560),dyslipidemia(OR=2.620),and anti-HBc positive(OR=3.001)were independent risk factors for the outcome of polypoid lesion of gallbladder.Conclusion Polypoid lesion of gallbladder is affected by ethnicity,body mass index,hypertension,diabetes,and anti-HBc,and there are significant differences in clinical outcomes among patients with different characteristics.