累积体质量指数对新发胆石症的预测价值  

Predictive value of cumulative body mass index on new-onset cholelithiasis

作　　者：刘通[1,2] 王一鸣[1,2] 司天福 王万超[2] 曹立瀛[2] 刘四清[2] Liu Tong Wang Yiming Si Tianfu Wang Wanchno Cao Liying Liu Siqing(Graduate School, North China University of Science and Technology, Tangshan 063000, Hebei Province, Chin)

机构地区：[1]华北理工大学研究生学院,唐山063000 [2]华北理工大学附属开滦总医院肝胆外科

出　　处：《中华消化外科杂志》2017年第2期188-194,共7页Chinese Journal of Digestive Surgery

摘　　要：目的：探讨累积体质量指数（cumBMI）对新发胆石症的影响。方法：采用回顾性队列研究方法。收集2006、2008、2010、2012、2014年开滦总医院、开滦林西医院、开滦赵各庄医院、开滦唐家庄医院、开滦范各庄医院、开滦吕家坨医院、开滦荆各庄医院、开滦林南仓医院、开滦钱家营医院、开滦马家沟医院、开滦医院分院行健康体检的31794例受试者的体检资料。将受试者依据cumBMI四分位数分为4组：7949例受试者cumBMI〈140.81kg/m^2×年设为Q1组；7946例受试者140.81kg/m^2×年≤cumBMI〈159.69kg/m^2×年设为Q2组；7949例受试者159.69kg/m^2×年≤cumBMI〈180.49kg/m^2×年设为Q3组；7950例受试者cumBMI≥180.49kg/m^2×年设为Q4组。由固定医师团队2006、2008、2010、2012、2014年在相同地点对受试者进行5次健康体检。收集流行病学调查内容、人体测量学指标、生化指标。观察指标：（1）4组受试者胆石症的发病情况。（2）影响受试者新发胆石症的危险因素分析：性别、年龄、cumBMI、BMI、饮酒、吸烟、体育锻炼、高血压病、糖尿病、C反应蛋白、TG、TC。正态分布的计量资料以x^-±s表示，多组间比较采用单因素方差分析；两两比较，方差齐采用LSD检验，方差不齐采用Dunnett′sT3检验。偏态分布的计量资料采用M（Q）表示，多组间比较采用非参数检验。计数资料比较用χ^2检验。采用KaplanMeier法计算不同cumBMI组受试者胆石症的发病率，不同cumBMI分组中胆石症发病率比较采用Logrank检验。采用COX比例风险模型进行单因素和多因素分析。结果：（1）4组受试者胆石症的发病情况：31794例受试者在（2.1±0.4）年的观察研究中，新发胆石症236例，发病率为7.42‰。Q1、Q2、Q3、Q4组受试者胆石症发病率分别为4.03‰、7.17‰、7.93‰、10.57‰，4组受试者发病率比较，差异有统计学意义（χ^2=72.39，P〈0.05）。（2�Objective：To investigate the predictive value of cumulative body mass index （cumBMI） on newonset cholelithiasis. Methods：The retrospective cohort study was conducted. The data of 31 794 subjects who participated health examination at the Kailuan Hospital, Kailuan Linxi Hospital, Kailuan Zhaogezhuang Hospital, Kailuan Tangjiazhuang Hospital, Kailuan Fan′gezhuang Hospital, Kailuan Lyujiatuo Hospital, Kailuan Jinggezhuang Hospital, Kailuan Linnancang Hospital, Kailuan Qianjiaying Hospital, Kailuan Majiagou Hospital and Kailuan Branch Hospital in 2006, 2008, 2010, 2012 and 2014 were collected. All the subjects were allocated into 4 groups according to squartiles of cumBMI： 7 949 with cumBMI〈140.81 kg/m^2×year in the Q1 group, 7946 with 140.81 kg/m^2×year≤cumBMI〈159.69 kg/m^2×year in the Q2 group, 7 949 with 159.69 kg/m^2×year≤cumBMI〈180.49 kg/m^2×year in the Q3 group and 7 950 with cumBMI≥180.49 kg/m^2×year in the Q4 group. All the subjects received respectively the five health examinations in 2006, 2008, 2010, 2012 and 2014 at the same place. Epidemiological investigation, anthropometric parameters and biochemical indicators were collected. Observation indicators： （1） incidence of cholelithiasis in the 4 groups; （2）risk factors analysis affecting newonset cholelithiasis： sex, age, cumBMI, BMI, drinking, smoking, physical exercise, hypertension, diabetes, Creactive protein （CRP）, triglyceride（TG） and total cholesterol （TC）. Measurement data with normal distribution were represented as x^-±s and comparisons among groups were analyzed using the oneway ANOVA. Pairwise comparison and homogeneity of variance were done using the LSD test. Heterogeneity of variance was done using the Dunnett′s T3 test. Measurement data with skewed distribution were described as M （Q） and comparisons among groups were analyzed using the nonparametric test. Count data were analyzed by the chisquare test. The incidence of cholelithiasis in the 4 groups were calculated by the KaplanMe

关 键 词：胆石症 累积体质量指数 发病率 

分 类 号：R657.4[医药卫生—外科学]