不同类型胆囊结石患者流行病学特征及结石成分与脂代谢、肝功能指标的相关性研究  

Epidemiological characteristics of patients with different types of gallstones and correlation analysis of stone components with lipid metabolism and liver function indexes

作　　者：叶锡银 张小玲 王三贵 YE Xiyin;ZHANG Xiaoling;WANG Sangui(Department of Hepatobiliary Surgery,Dongguan Nancheng Hospital,Dongguan Guangdong 523071,China)

机构地区：[1]东莞市南城医院肝胆外科,广东东莞523071

出　　处：《新疆医科大学学报》2024年第9期1242-1247,共6页Journal of Xinjiang Medical University

基　　金：广东卫生健康委员会科研项目(20221352);东莞市社会科技发展重点项目(202050715008219)。

摘　　要：目的研究不同类型胆囊结石患者的流行病学特征,及结石成分与患者脂代谢、肝功能指标的相关性。方法选择2021年1月-2023年12月东莞市南城医院肝胆外科收治的308例单纯性胆囊结石患者为研究对象。采用第二代智能红外光谱结石分析仪对结石标本进行成分分析,将患者根据胆结石类型分为胆固醇型结石组、胆色素型结石组、胆固醇-胆色素混合型结石组和其他类型结石组。收集所有患者的流行病学特征,记录脂代谢和肝功能指标。采用Spearman相关性分析不同类型胆囊结石组胆固醇、胆红素、胆酸含量与脂代谢、肝功能指标的相关性。结果在308份胆囊结石标本中,胆固醇型结石145例,胆色素性结石91例,胆固醇-胆色素混合型结石52例,其他类型结石20例。4组患者的性别、BMI和肝病发生情况比较,差异有统计学意义(P<0.05)。两两比较分析结果显示,与胆固醇型结石组比较,胆色素型结石组、胆固醇-胆色素混合型结石组和其他类型结石组中女性、BMI≥24 kg/m^(2)、高血脂的比例、血清胆固醇(CHOL)、三酰甘油(TG)水平显著降低,差异有统计学意义(P<0.05)。胆色素型结石组和胆固醇-胆色素混合结石组的血清碱性磷酸酶(ALP)水平显著高于胆固醇型组和其他类型组,胆色素型组总胆红素(TBIL)水平显著高于其他3组,差异有统计学意义(P<0.05)。胆固醇型结石组的胆固醇含量显著高于其他3组,胆色素性结石组的胆红素含量显著高于其他3组,其他类型结石组的胆酸含量显著高于其他3组,差异有统计学意义(P<0.05)。在胆固醇型结石组中,结石中胆固醇含量与患者CHOL水平呈显著正相关关系(P<0.05);在胆色素型结石组中,结石中胆色素含量与患者ALP水平呈显著正相关关系(P<0.05)。结论不同类型胆囊结石患者性别、BMI、高血脂症的占比、血清CHOL、TG、ALP和TBIL水平存在差异。Objective To study the epidemiological characteristics of thepatients with different types of gallstones and the correlation between stone components and lipid metabolism and liver function.Methods 308 patients with simple gallstones admitted to the hospitalfrom January 2021 to December 2023 were selected as study objects.The second generation of intelligent infrared spectroscopic calculi analyzer was used to analyze the composition of the calculi specimens,and the patients were divided into cholesterol calculi group,bile pigment calculi group,cholesterol-bile pigment mixed calculi group and other calculi group according to the types of gallstones.Epidemiological characteristics of all patients were collected,and lipid metabolism and liver function indicators were recorded.Spearman correlation analysis was used to evaluate the relationship between the contents of cholesterol,bilirubin,cholic acid and lipid metabolism and liver function in different types of gallstone groups.Results Among 308 specimens of gallstones,145 were cholesterol-type stones,91 were cholecithal stones,52 were cholesterol-cholecithal stones and 20 were other types of stones.There were significant differences in gender,BMI and liver disease occurrence among the 4 groups(P<0.05).2 comparative analysis,according to the results of comparing with the type of cholesterol stone group,bile pigment type group,the cholesterol to bile pigment mixed stones and other types of stones in groups of women,the proportion of BMI,24 kg/m^(2) or high cholesterol,serum cholesterol(CHOL),3 acyl glycerin(TG)were significantly reduced,the difference were statistically significant(P<0.05).The serum alkaline phosphatase(ALP)level in bile pigment type stone group and cholesterol-bile pigment mixed stone group was significantly higher than that in cholesterol type and other types of the patients,and the total bilirubin(TBIL)level in bile pigment type stone group was significantly higher than that in the other 3 groups,with statistical significance(P<0.05).The content of

关 键 词：胆囊结石 流行病特征 脂代谢 肝功能 

分 类 号：R575.6[医药卫生—消化系统]