胆固醇类结石患者血脂水平和胆汁成分对其术后结石复发的预测价值分析  

Predictive value of blood lipid and bile component for postoperative recurrence in patients with cholesterol stones

作　　者：刘连波 杨学知 叶智 LIU Lianbo;YANG Xuezhi;YE Zhi(Department of Hepatobiliary and Pancreatic Surgery,363 Hospital,Chengdu 610097,China)

机构地区：[1]三六三医院肝胆胰外科,四川成都610097

出　　处：《陕西医学杂志》2024年第1期59-63,共5页Shaanxi Medical Journal

基　　金：四川省卫生信息学会科研课题(2022036);通用技术集团医疗健康有限公司科研课题(TYYLKYJJ-2022-048)

摘　　要：目的:探讨胆固醇类结石患者血脂水平和胆汁成分对其术后结石复发的预测价值。方法:选取39例行手术治疗后再复发的胆固醇类结石患者为复发组,另选取同期收治78例术后未复发胆固醇类结石患者为未复发组,比较两组患者血脂水平和胆汁成分变化,受试者特征曲线分析血脂水平和胆汁成分对胆固醇类结石患者术后复发的预测价值,分析胆固醇类结石患者术后复发危险因素。结果:复发组BMI≥28kg/m2、结石数量≥2枚患者占比分别为48.72%、74.36%,均高于未复发组的29.49%、53.85%(均P<0.05)。复发组患者总胆固醇(TC)、甘油三酯(TG)水平和胆汁胆固醇(CHO)高于未复发组(均P<0.05)。受试者特征曲线分析显示血TC、TG、胆汁CHO水平及其联合检测对术后结石复发的曲线下面积分别为0.711、0.718、0.727、0.871,联合检测的曲线下面积高于其单独检测(均P<0.05)。多因素Logistic回归分析显示TC>4.850mmol/L、TG>1.455mmol/L、胆汁CHO>96.975mmol/L、BMI≥28kg/m2、结石数量≥2枚是胆固醇类结石患者术后结石复发危险因素(均P<0.05)。结论:TC、TG、胆汁CHO水平联合检测能提高胆固醇类结石患者术后结石复发预测价值,其水平异常升高、肥胖和结石数量多会增加术后结石复发风险。Objective:To explore the predictive value of blood lipid and bile component for postoperative recurrence in patients with cholesterol stones.Methods:A total of 39 patients with postoperative recurrence of cholesterol stones and 78 patients without recurrence were enrolled as recurrence group and non-recurrence group,respectively.The changes in blood lipid level and bile component were compared between the two groups.The predictive value of blood lipid and bile component for postoperative recurrence in patients with cholesterol stones was analyzed by receiver operating characteristic(ROC)curve,and the risk factors of postoperative recurrence were analyzed.Results:The proportions of cases with BMI≥28 kg/m 2 and number of stones≥2 in recurrence group was 48.72%and 74.36%,higher than those in non-recurrence group(29.49%,53.85%,all P<0.05).The levels of total cholesterol(TC),triglyceride(TG)and bile cholesterol(CHO)in recurrence group were higher than those in non-recurrence group(all P<0.05).ROC curves analysis showed that area under the curve(AUC)values of TC,TG,bile CHO and combined detection for predicting postoperative stone recurrence were 0.711,0.718,0.727 and 0.871,respectively.AUC of combined detection was greater than that of single index(all P<0.05).Multivariate Logistic regression analysis showed that TC>4.850 mmol/L,TG>1.455 mmol/L,bile CHO>96.975 mmol/L,BMI≥28 kg/m 2 and stone number≥2 were risk factors of postoperative recurrence in patients with cholesterol stones(all P<0.05).Conclusion:The combined detection of TC,TG and bile CHO can improve predictive value of postoperative recurrence in patients with cholesterol stones.The abnormal increase of the three indexes,obesity and increased number of stones will increase the risk of postoperative stone recurrence.

关 键 词：胆固醇类结石 血脂 胆汁成分 术后复发 预测价值 危险因素 

分 类 号：R575.62[医药卫生—消化系统]