代谢综合征对新发胆石症的预测价值  

Predictive value of metabolic syndrome on new-onset cholelithiasis

作　　者：刘通[1,3] 高海静 王万超[3] 王一鸣[3] 刘四清 曹立瀛[3] 刘希宁[3] 李海涛[4] 

机构地区：[1]华北理工大学研究生院,唐山063000 [2]华北理工大学临床学院 [3]华北理工大学附属开滦总医院肝胆外科 [4]河北省遵化市人民医院外科一病区,064200

出　　处：《中华消化外科杂志》2017年第6期608-613,共6页Chinese Journal of Digestive Surgery

基　　金：河北省卫生计生委重点科技研究计划（20171435）

摘　　要：目的：探讨代谢综合征（MS）对新发胆石症的预测价值。 方法：采用回顾性队列研究方法。收集2006年6月至2015年12月华北理工大学附属开滦总医院、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89 553例受试者的体检资料。按照国际糖尿病联盟对MS的诊断标准将受试者分为4组，70 657例无MS受试者为正常人群组，14 075例满足3条MS诊断标准的受试者设为MS3组、4 556例满足4条MS诊断标准的受试者设为MS4组、265例满足5条MS诊断标准的受试者设为MS5组。由固定医师团队在相同地点对受试者进行健康体检。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组受试者的临床特征比较。（2）受试者胆石症的发病情况。（3）影响受试者新发胆石症的危险因素分析。正态分布的计量资料以±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′s T3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KruskalWallis检验。计数资料比较采用x2检验。采用KaplanMeier法计算不同分组间胆石症的发病率，组间胆石症发病率比较采用Logrank检验。采用COX比例风险模型分析MS对新发胆石症的风险比（HR）和95%可信区间。 结果：（1）4组受试者的临床特征比较：正常人群组年龄、性别（男性）、收缩压、舒张压、腰围、TG、TC、高密度脂蛋白胆固醇、空腹血糖、BMI、高血压病、糖尿病、饮酒、吸 烟及体育锻炼人数分别为（50±12）岁、52 895例、（127±20）mmHg（1mmHg=0.133kPa）、（81±11）mmHg、 （85±9）cm、1.14 mmol/L（0.83～1.56 mmol/L）、（4.9±1.1）mmol/L、（1.56±0.39）mmolObjective：To investigate the predictive value of metabolic syndrome （MS） on newonset cholelithiasis. Methods：The retrospective cohort study was conducted. The data of 89 553 subjects who participated health examination at the Kailuan General Hospital Affiliated to the North China University of Science and Technology, 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 from June 2006 to December 2015 were collected. According to the diagnostic criteria of MS published by International Diabetes Federation, all the patients were divided into 4 groups, including 70 657 without MS in the normal group, 14 075 corresponded with 3 diagnostic criteria of MS in the MS3 group, 4 556 corresponded with 4 diagnostic criteria of MS in the MS4 group and 265 corresponded with 5 diagnostic criteria of MS in the MS5 group.Health examinations were applied to all subjects by the fixed team of doctors at the same place. Epidemiological investigation, anthropometric parameters and biochemical indicators were collected. Observation indicators： （1） comparisons of clinical characteristics among the 4 groups; （2） incidence of cholelithiasis in the 4 groups; （3） risk factors analysis affecting newonset cholelithiasis. Measurement data with normal distribution were represented as ±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 KruskalWallis test. Comparisons of count data were analyzed by the chisquare test. The incidence of cholelithiasis in the 4 groups were calculated by the Kaplan

关 键 词：胆石症 代谢综合征 发病率 

分 类 号：R575.62[医药卫生—消化系统] R589[医药卫生—内科学]