结直肠腺瘤与患者血脂代谢水平  

Characteristic analysis of plasma lipid metabolism level in patients with colorectal adenoma

作　　者：李传凤[1] 李军[1] 白鹏[1] 吕愈敏[1] 

机构地区：[1]北京大学第三医院消化科,北京100191

出　　处：《北京大学学报（医学版）》2011年第3期432-435,共4页Journal of Peking University:Health Sciences

摘　　要：目的:研究结直肠腺瘤患者的血脂水平,明确血脂水平是否影响结直肠腺瘤的发生,同时分析不同血脂水平的腺瘤患者腺瘤发生部位是否存在差异。方法:对2009年5月至2010年2月在北京大学第三医院进行结肠镜检查的患者进行回顾性分析,将结肠镜检查发现结直肠腺瘤的患者纳入腺瘤组,将内镜检查无明显异常的患者纳入对照组,并且两组患者均无结直肠腺癌、结直肠手术史及影响血脂水平的药物服用史,统计各组患者血总胆固醇、甘油三酯、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇水平及腺瘤发生部位。结果:共有227例患者纳入本研究,其中腺瘤组124人,男性77人,女性47人,平均年龄(56.5±10.7)岁,对照组103人,男性53人,女性50人,平均年龄(56.8±13.6)岁。腺瘤组甘油三酯水平(1.83±1.04)mmol/L,明显高于对照组(1.54±0.86)mmol/L(P=0.022),腺瘤组HDL-C水平(1.05±0.32)mmol/L,明显低于对照组(1.26±0.46)mmol/L(P=0.000),腺瘤组HDL-C降低者共73例,显著多于对照组44例(P=0.015),此外,甘油三酯升高组和HDL-C降低组患者近侧结肠腺瘤的发生率(39.8%、37.4%)均高于正常对照组(25.5%),但差异无统计学意义(P=0.358)。结论:高脂血症可影响结直肠腺瘤的发生,尤其是高甘油三酯血症及血清HDL-C水平降低更为明显。由于血甘油三酯水平与饮食构成有关,因此,控制饮食,改善饮食结构可能具有预防结直肠腺瘤发生的作用,同时甘油三酯升高组和HDL-C降低组患者近侧结肠腺瘤的发生率似乎较正常对照组为高,应继续扩大样本量进行深入研究。Objective：To evaluate the relationship between serum lipid level and colorectal adenoma.Methods：A review analysis was carried out of the patients who underwent colonoscopy in Peking University Third Hospital from May 2009 to February 2010.Subjects with history of colorectal adenocarcinoma before colorectal surgery or of medication which had influenced the serum lipid level were excluded.Adenoma group included the patients who had colorectal adenoma which was evidenced by pathology.The patients with no adenoma were ascribed to control group.The serum total cholesterol,triglyceride,HDL cholesterol and LDL cholesterol levels of the two groups were analyzed.The relation between serum lipid level and location of colorectal adenoma was also summarized.Results：A total of 227 patients were included for final analysis,of whom 124 were in adenoma group（77 males and 47 females;mean age：56.5±10.7 years）and 103 in control group（53 males and 50 females;mean age：56.8±13.6 years）.Serum triglyceride level in adenoma group [（1.83±1.04） mmol/L] was significantly higher than that of control group[（1.54±0.86） mmol/L（P=0.022）] and HDL-C level in adenoma group[（1.05±0.32） mmol / L] was significantly lower than that of control group [（1.26±0.46） mmol/L（P=0.000）].In adenoma group,73 cases were with HDL-C decreased,which was significantly higher than that of control group（44 cases,P=0.015）.In addition,higher incidence of proximal colonic adenomas was observed in elevated triglycerides group and low HDL-C group（39.8%,37.4%）,compared with control group（25.5%）,but there was no statistical difference between the two groups（P=0.358）.Conclusion：The findings of this study suggest that dyslipidemia may affect the incidence of colorectal adenoma,particularly hypertriglyceridemia and low HDL-C levels.In addition,higher triglyceride and lower HDL-C levels seem to be related to higher incidence of proximal colonic adenomas.

关 键 词：结直肠肿瘤 腺瘤 高脂血症 高甘油三酯 脂蛋白类 HDL胆固醇 

分 类 号：R735.35[医药卫生—肿瘤]