单发结直肠大腺瘤的危险因素分析  

Analysis of risk factors for single colorectal macroadenoma

作　　者：贾明科 薛媛媛 Jia Mingke;Xue Yuanyuan(Department of Gastroenterology,The First Hospital of Yulin,Yulin 719000,China;Department of Medical Record Statistics,The First Hospital of Yulin,Yulin 719000,China)

机构地区：[1]榆林市第一医院消化内科,榆林719000 [2]榆林市第一医院病案统计室,榆林719000

出　　处：《中国临床实用医学》2024年第6期43-48,共6页China Clinical Practical Medicine

摘　　要：目的探讨单发结直肠大腺瘤(最长径≥1 cm)发生的危险因素。方法本研究为回顾性病例对照研究,选取2016年1月至2023年6月榆林市第一医院消化内科收治的经内镜治疗的183例单发结直肠大腺瘤患者纳入大腺瘤组,男102例,女81例,年龄(62.12±11.53)岁,年龄范围为23~83岁。按照年龄、性别1∶1匹配同期榆林市第一医院消化内科住院行胃肠镜检查无息肉的183例胃肠功能紊乱患者纳入无腺瘤组,男102例,女81例,年龄(62.12±11.53)岁,年龄范围为23~83岁。收集所有患者的资料,并采用多因素logistic回归分析影响大腺瘤发生的独立危险因素,绘制大腺瘤的列线图模型。结果大腺瘤组患者吸烟比例[16.9%(31/183)]、胆囊疾病比例[15.8%(29/183)]、肠癌家族史比例[7.7%(14/183)]、粪便潜血实验(FOBT)阳性比例[21.9%(40/183)]、中性粒细胞与淋巴细胞绝对值比值(NLR,2.67±1.32)、甘油三酯[(1.47±0.77)mmol/L]、糖类抗原199[(10.63±7.58)U/ml]高于无腺瘤组[8.2%(15/183)、7.6%(14/183)、2.7%(5/183)、8.7%(16/183)、2.28±0.88、(1.26±0.57)mmol/L、(6.80±6.05)U/ml];大腺瘤组患者淋巴细胞绝对值[(1.50±0.51)×10^(9)/L]、血红蛋白[(137.93±16.20)g/L]低于无腺瘤组[(1.63±0.48)×10^(9)/L、(141.67±13.51)g/L],差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,吸烟、FOBT阳性、NLR升高、血红蛋白降低、甘油三酯升高、糖类抗原199升高是大腺瘤发生的独立危险因素(P<0.05)。结论单发结直肠大腺瘤发生的独立危险因素包括吸烟、NLR升高、甘油三酯升高、FOBT阳性,在大腺瘤异型增生过程中,糖类抗原199的表达会上调,血红蛋白因肠道失血会有所下降。Objective:To investigate the risk factors of single colorectal macroadenoma(the longest diameter≥1 cm).Methods:This study was a retrospective case-control study,a total of 183 endoscopic patients with single colorectal macroadenoma admitted to department of Gastroenterology in The First Hospital of Yulin from January 2016 to June 2023 as macroadenoma group,including 102 males and 81 females,aged(62.12±11.53)years old,the age ranging from 23 to 83 years old.According to age and gender 1∶1 matching 183 patients with gastrointestinal dysfunction admitted in the department of Gastroenterology of The First Hospital of Yulin during the same period without polyps were included in the adenoma-free group,including 102 males and 81 females,aged(62.12±11.53)years old,the age ranging from 23 to 83 years old.The data of all patients were collected,and the independent risk factors affecting the occurrence of macroadenoma were analyzed by multivariate logistic regression,and the nomogram model of macroadenoma was drawn.Results:In the macroadenoma group,the proportion of smoking[16.9%(31/183)],gallbladder disease[15.8%(29/183)],family history of bowel cancer[7.7%(14/183)],positive fecal occult blood test[FOBT,21.9%(40/183)],neutral lymphatic ratio(NLR,2.67±1.32),triglyceride[(1.47±0.77)mmol/L],carbohydrate antigen 199[(10.63±7.58)U/ml]were higher than those in the adenoma-free group[8.2%(15/183),7.6%(14/183),2.7%(5/183),8.7%(16/183),2.28±0.88,(1.26±0.57)mmol/L,(6.80±6.05)U/ml].Lymphocytes[(1.50±0.51)×10^(9)/L]and hemoglobin[(137.93±16.20)g/L]in macroadenoma group were lower than those in the adenoma-free group[(1.63±0.48)×10^(9)/L,(141.67±13.51)g/L],and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that smoking,positive FOBT,elevated NLR,decreased hemoglobin,elevated triglyceride and elevated carbohydrate antigen 199 were independent risk factors for macroadenoma(P<0.05).Conclusions:The independent risk factors for single colorectal macroadenoma include sm

关 键 词：腺瘤 结直肠 甘油三酯 糖类抗原199 中性粒细胞与淋巴细胞绝对值比值 

分 类 号：R735.34[医药卫生—肿瘤]