青年人群结直肠息肉的临床特征及相关因素

Clinical characteristics and related factors of colorectal pol⁃yps in young population

目的:分析青年人群结直肠息肉患病的发病特点及相关危险因素,为该人群的预防、早期筛查和治疗提供科学依据。方法:共收集首都医科大学附属北京友谊医院消化内镜中心行电子结肠镜检查且年龄≤40岁的患者443例,其中223例为结直肠息肉组,220例为正常对照组。总结青年人群结直肠息肉的临床和病理特点,分析青年人群结直肠息肉影响因素,比较两组在性别、体重、身高、体质量指数(BMI)、吸烟、饮酒、甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)、空腹血糖(FBG)、癌胚抗原(CEA)等方面的差异。结果:共检出并行活检的息肉有412枚。青年结直肠息肉的发病率男性高于女性,大多数患者未表现出临床症状。多数息肉为多发性,其中2~5个息肉的发生率最高,直径以0.6~0.9 cm为主,乙状结肠是最常见的部位,主要形态为扁平型(山田Ⅰ型)。病理类型以增生性、管状腺瘤和炎性息肉居多。发生结直肠息肉与性别、年龄、吸烟、饮酒、身高、体重、BMI、TC、LDL-C、HDL-C、UA、CEA均有相关性(P<0.05)。饮酒、CEA是青年结直肠息肉的独立危险因素(P<0.05)。结论:青年人群结直肠息肉的检出率呈上升趋势,受多种因素影响,应重视结肠镜的健康体检,特别是青年高危人群。同时加强早期筛查和健康教育。

Objective:To analyze the characteristics of onset and related risk factors of colorectal polyps in young people,and to provide scientific basis for the prevention,early screening,and treatment of this population.Methods:A total of 443 patients aged≤40 years,who underwent electronic colonoscopy at the Gastrointestinal Endoscopy Center of Beijing Friendship Hospital,Capital Medical University,were collected.Among them,223 cases were included in the colorectal polyp group,and 220 cases were included in the normal control group.The clinical and pathological characteristics of colorectal polyps in young people were summarized,and the related factors of colorectal polyps in young people were analyzed,compared the differences between the two groups in aspects such as gender,weight,height,body mass index(BMI),smoking,drinking,triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),blood uric acid(UA),fasting blood glucose(FBG),and carcino-embryonic antigen(CEA).Results:A total of 412 polyps were detected and biopsied.The incidencerate of colorectal polyps was higher in males,with the majority of patients presented as asymptomatic.Most polyps were multiple,with the highest incidence rate of 2-5 polyps,mainly in the range of 0.6-0.9 cm in diameter.The sigmoid colon be the most common site,and the main morphology was flat(Yamada type I).The pathological types were predominantly hyperplastic,adenomatous,and inflammatory polyps.The occurrence of colorectal polyps in young adults was correlated with gender,smoking,alcohol,height,BMI,TC,LDL-C,HDL-C,UA,and CEA(P<0.05);alcohol consumption and CEA were independent risk factors for colorectal polyps in young people(P<0.05).Conclusion:The detection rate of colorectal polyps in youth population is on the rise,influenced by a variety of factors,and it is important to pay attention to the health examination of colonoscopy,especially for high-risk young groups.At the same time,strengthen early screening and health education.