高血压患者结直肠息肉发病的危险因素分析  

Analysis of risk factors of colorectal polyps in patients with hypertension

作　　者：邢洁[1] 任竣瑶 张倩 孙秀静[1] 岳冰[2] 李荣雪[1] 朱圣韬[1] 李鹏[1] 张澍田[1] XING Jie;REN Jun-yao;ZHANG Qian(Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,National Clinical Research Center for Digestive Disease,Beijing Digestive Disease Center,Beijing Key Laboratory for Precancerous Lesion of Digestive Disease,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院消化内科,国家消化系统疾病临床医学研究中心,北京市消化疾病中心,消化疾病癌前病变北京市重点实验室,北京100050 [2]首都医科大学附属北京友谊医院病理科,北京100050

出　　处：《临床和实验医学杂志》2021年第16期1723-1727,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金项目(编号:81802310);北京市医院管理中心消化内科学科协同发展中心专项项目(编号:XXZ01,XXZ02);北京市自然科学基金(编号:7204249)。

摘　　要：目的探讨高血压患者结直肠息肉发生的相关危险因素。方法回顾性分析2013年3月至2014年11月于首都医科大学附属北京友谊医院行结肠镜检查的高血压患者共212例,其中95例经内镜诊断为结直肠息肉且病理证实为非肿瘤性病变者入病例组,余117例研究对象内镜检查为其他非息肉性病变或未见明显异常者入对照组。收集患者年龄、性别、体重指数、基本信息、个人史、既往史、肠道清洁度等信息,统计分析高血压患者发生结直肠息肉的相关危险因素。结果共纳入高血压患者212例。其中息肉组95例,对照组117例。采用独立样本t检验显示,息肉组年龄[(58.88±6.20)岁]高于对照组[(56.16±7.21)岁],差异有统计学意义(P<0.05)。采用χ^(2)检验显示,息肉组中男性患者比率(61.1%)高于对照组(45.3%),同时息肉组饮酒及息肉史的患者比率(50.55%、28.4%)高于对照组(29.1%、15.4%),差异均有统计学意义(P<0.05)。两组间年龄、性别、饮酒及息肉史是影响结直肠息肉发生的因素(P<0.05),而与民族、婚姻、教育、劳动强度、吸烟、慢性疾病史等无关(P>0.05);多因素Logistic回归模型分析结果显示,年龄(P<0.001)及饮酒(P <0.001)是高血压患者发生结直肠息肉的独立危险因素,据此构建预测模型,多因素Logistic回归模型预测高血压患者结直肠息肉的曲线下面积与一致性指数均为0.684,对于高血压患者发生结直肠息肉具有一定的预测作用。结论年龄及饮酒可能是高血压患者发生结直肠息肉的独立危险因素,在行结肠镜术前筛查过程中,综合考虑高血压人群发生结直肠息肉的危险因素,评估高血压患者发生结直肠息肉的风险,可以更有针对性地进行结肠镜检查,从而提高高血压患者结直肠息肉的检出率,避免医疗资源不必要的浪费。Objective To investigate the risk factors of colorectal polyps in patients with hypertension. Methods A total of 212 patients with hypertension who underwent colonoscopy in the Endoscopy Center of Beijing FriendshipHospital,Capital Medical University from March 2013 to November 2014 were analyzed retrospectively. Ninety five patients with colorectal polyps diagnosed by endoscopy and pathologically confirmed as non-neoplastic lesions were included in the case group. and the remaining 117 subjects served as control group. Patients’ age,sex,BMI,basic information,family history,intestinal cleanliness and other factors were collected to statistically analyze the risk factors related to colorectal polyps in patients with hypertension. Results In total,212 patients with hypertension were included in this study. There were 95 cases in the polyp group and 117 cases in the control group. The independent sample t test showed that the age of the polyp group [(58. 88 ± 6. 20) years]was higher than that of the control group [(56. 16 ± 7. 21) years],and the difference was statistically significant(P<0.05). The chi-square test showed that the proportion of male patients of the polyp group(61. 1%) was higher than that of the control group(45. 3%),and the proportion of patients with alcohol and polyp history of the polyp group(50. 55%,28. 4%) was higher than that of the control group(29. 1%,15. 4%),the differences were statistically significant(P<0.05). Age,sex,drinking and history of polyps were the factors affecting the occurrence of colorectal polyps between the two groups(P<0.05),but had nothing to do with nationality,marriage,education,labor intensity,smoking,history of chronic diseases and so on(P>0.05). The results of multivariate logistic regression model analysis showed that age(P < 0. 001) and drinking(P < 0. 001) were independent risk factors for colorectal polyps in patients with hypertension. The multivariate regression model predicts colorectal polyp in hypertensive patients with the area under the curve and the

关 键 词：结直肠息肉 检出率 危险因素 筛查 

分 类 号：R544.1[医药卫生—心血管疾病] R574.6[医药卫生—内科学]