血脂水平对胆总管取石术及胆囊切除术后复发性胆总管结石的影响  

Effect of serum lipid levels on recurrent choledocholithiasis.after choledocholithotomy and cholecystectomy

作　　者：邱艳 陈佳云 刘士花 左溶 王路路 庄颖 QIU Yan;CHEN Jiayun;LIU Shihua;ZUO Rong;WANG Lulu;ZHUANG Ying(Department of Gastroenterology,First Affiliated Hospital,Naval Medical University,Shanghai 200433,CHINA)

机构地区：[1]海军军医大学第一附属医院消化内科,上海200433

出　　处：《江苏医药》2024年第7期729-732,共4页Jiangsu Medical Journal

摘　　要：目的 探讨血脂水平对胆总管取石术及胆囊切除术后复发性胆总管结石的影响。方法 303例胆总管结石患者行内镜逆行胰胆管造影(ERCP)胆总管取石术及胆囊切除术,中位随访时间66个月。61例患者发生复发性胆总管结石(复发组),242例患者未发生复发性胆总管结石(未复发组)。收集相关资料,采用Cox回归分析复发性胆总管结石的影响因素。结果 与未复发组比较,复发组患者年龄较大,HbA1c水平较高,AST、ALT、总胆红素和γ-谷氨酰转肽酶水平较低,TG>1.82 mmol/L、LDL>3.1 mmol/L、TC>5.2 mmol/L比例较高,HDL≥0.9 mmol/L比例较低(P<0.05)。TC>5.2 mmol/L是复发性胆总管结石的独立危险因素,HDL≥0.9 mmol/L是复发性胆总管结石的独立保护因素(P<0.01)。结论 对于行ERCP胆总管取石术及胆囊切除术的患者,血脂水平是复发性胆总管结石的影响因素。Objective To investigate the effect of serum lipid levels on the recurrent choledocholithiasis after choledocholithotomy and cholecystectomy.Methods A total of 303 patients with choledocholithiasis underwent choledocholithotomy and cholecystectomy by endoscopic retrograde cholangiopancreatography(ERCP)were followed up for a median follow-up time of 66 months,of whom 61 patients developed recurrent choledocholithiasis(group A)and 242 patients did not(group B).The relevant clinical data were collected.Cox regression was used to analyze the influencing factors for the recurrent choledocholithiasis.Results Compared with group B,the age of group A was older,HbAlc was higher,AST,ALT,total bilirubin and-glutamyltranspeptidase were lower,the percentages of the patients with TG>1.82 mmol/L,LDL>3.1 mmol/L and TC>5.2 mmol/L were higher,and the percentage of those with HDL≥0.9 mmol/L was lower(P<0.05).TC>5.2 mmol/L was the independent risk factor for the recurrent choledocholithiasis,and HDL≥0.9 mmol/L was the independent protective factor(P<0.01).Conclusion Serum lipid levels are the influencing factors for the recurrent choledocholithiasisin the patients after choledocholithotomy and cholecystectomy by ERCP.

关 键 词：复发性胆总管结石 血脂 胆总管取石术 胆囊切除术 

分 类 号：R657[医药卫生—外科学]