發(fā)布時(shí)間：2018-04-23 11:43

  本文選題：結(jié)直腸息肉 + 代謝綜合征　； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:結(jié)直腸息肉是消化系統(tǒng)常見疾病,現(xiàn)已明確其為結(jié)直腸癌前病變。幽門螺桿菌感染也是消化系統(tǒng)常見疾病,其為胃、十二指腸炎癥及潰瘍的病因,并且與胃癌具有明確的相關(guān)性。代謝綜合征為一種高發(fā)的代謝紊亂綜合癥候群,已明確其為心腦血管疾病的危險(xiǎn)因素。許多臨床研究及薈萃分析指出這三種高發(fā)疾病可能存在著一定的相關(guān)性,本研究正是圍繞這三種疾病是否存在相關(guān)性以及存在怎樣的相關(guān)性而展開,旨在為相關(guān)領(lǐng)域的研究提供新的證據(jù),為相關(guān)科室的臨床工作提供一定的參考。方法:本研究對(duì)符合納入標(biāo)準(zhǔn)的213例患者的相關(guān)臨床資料進(jìn)行記錄、整理,并將其分成不同的組分進(jìn)行比較。首先將其分為結(jié)直腸息肉組與對(duì)照組、腺瘤性息肉組與非腺瘤性息肉組、高危腺瘤組與非高危腺瘤組,左半結(jié)腸組、右半結(jié)腸組及全結(jié)腸組,分別對(duì)各組的年齡、性別、代謝相關(guān)疾病患病情況、代謝綜合征患病率及代謝綜合征各組分進(jìn)行比較以明確結(jié)直腸息肉與代謝綜合征之間是否具有相關(guān)性,具有怎樣的相關(guān)性。接下來再將以上分組的幽門螺桿菌陽(yáng)性率進(jìn)行比較以明確結(jié)直腸息肉與幽門螺桿菌感染之間是具有相關(guān)性,具有怎樣的相關(guān)性。最后將213例患者重新分為幽門螺桿菌陽(yáng)性組與幽門螺桿菌陰性組,將兩組的代謝相關(guān)疾病患病情況、代謝綜合征患病率及代謝綜合征各組分進(jìn)行比較以明確幽門螺桿菌感染與代謝綜合征之間是否具有相關(guān)性,具有怎樣的相關(guān)性。結(jié)果:1、結(jié)直腸息肉組患者平均年齡57.20±10.92,高于對(duì)照組患者平均年齡52.72±13.17,差異具有統(tǒng)計(jì)學(xué)意義(P=0.008)。2、結(jié)直腸息肉組患者糖尿病患病率高于對(duì)照組,χ2=7.260,差異具有統(tǒng)計(jì)學(xué)意義(P=0.007)。3、結(jié)直腸息肉組患者代謝綜合征患病率高于對(duì)照組,χ2=6.640,差異具有統(tǒng)計(jì)學(xué)意義(P=0.010)。4、結(jié)直腸息肉組TG水平1.60(1.12,2.48),高于對(duì)照組1.31(0.96,1.91),差異具有統(tǒng)計(jì)學(xué)意義(P=0.003)。5、對(duì)結(jié)直腸息肉患者進(jìn)行非條件Logistic回歸檢驗(yàn),結(jié)果提示TG水平及糖尿病患病情況與結(jié)直腸息肉的發(fā)生之間存在正相關(guān),OR值分別為1.290和3.205,P0.05。6、高危腺瘤組患者平均年齡60.63±9.47,高于對(duì)照組患者平均年齡53.32±12.76,差異具有統(tǒng)計(jì)學(xué)意義(P=0.005)。7、腺瘤性息肉組患者HP陽(yáng)性率高于對(duì)照組,χ2=4.254,差異具有統(tǒng)計(jì)學(xué)意義(P=0.039)。8、高危腺瘤組與非高危腺瘤組,左半結(jié)腸組、右半結(jié)腸組及全結(jié)腸組的HP陽(yáng)性率差異無統(tǒng)計(jì)學(xué)意義。9、HP陽(yáng)性組與HP陰性組的代謝情況差異均無統(tǒng)計(jì)學(xué)意義。結(jié)論:(1)代謝綜合征為結(jié)直腸息肉的危險(xiǎn)因素,當(dāng)這些患者出現(xiàn)相應(yīng)消化系統(tǒng)癥狀時(shí),應(yīng)考慮行結(jié)直腸鏡檢查。(2)代謝綜合征組分中的甘油三酯水平及是否患有糖尿病為結(jié)直腸息肉的危險(xiǎn)因素,結(jié)直腸息肉高危人群應(yīng)積極控制代謝綜合征相關(guān)指標(biāo),尤其是甘油三脂及血糖水平。(3)高齡者發(fā)生結(jié)直腸息肉以及高危腺瘤的可能性大,對(duì)于高齡人群,尤其是合并其他危險(xiǎn)因素者可將結(jié)直腸鏡檢查作為體檢篩查項(xiàng)目之一。(4)幽門螺桿菌感染者發(fā)生腺瘤性息肉的可能性大,對(duì)于HP陽(yáng)性患者,尤其是合并其他危險(xiǎn)因素者,可考慮行幽門螺桿菌根除治療。(5)幽門螺桿菌與代謝綜合征之間無明顯相關(guān)性。
[Abstract]:Objective: colorectal polyps are common diseases of the digestive system and are now clearly defined as precancerous lesions. Helicobacter pylori infection is also a common disease of the digestive system. It is the cause of gastric, duodenal inflammation and ulcers, and has a clear correlation with gastric cancer. Metabolic syndrome is a high incidence of metabolic disorder syndrome, which has been clearly defined. It is a risk factor for cardiovascular and cerebrovascular diseases. Many clinical and meta-analysis points out that there may be a certain correlation between these three high incidence diseases. This study is based on the relevance and relevance of the three diseases. Clinical work provides some reference. Methods: the clinical data of 213 patients with the inclusion criteria were recorded, arranged and divided into different components. First, they were divided into colorectal polyp group and control group, adenomatous polyp group and non adenomatous polyp group, high risk adenoma group and non high risk adenoma group. In the left semicolon group, the right hemicolon group and the whole colon group, the age, sex, metabolic related diseases, metabolic syndrome and metabolic syndrome were compared to determine whether the correlation between colorectal polyps and metabolic syndrome was related. The positive rate of Helicobacter pylori was compared to determine the correlation between colorectal polyps and Helicobacter pylori infection. In the end, 213 patients were redivided into Helicobacter pylori positive group and Helicobacter pylori negative group, and the prevalence of metabolic syndrome, metabolic syndrome and metabolic syndrome in the two groups were analyzed. The results were as follows: 1, the average age of the patients in the colorectal polyp group was 57.20 + 10.92, higher than the average age of the control group of 52.72 + 13.17, with a statistically significant difference (P=0.008).2, and the sugar of the colorectal polyp group. The prevalence rate of urinary disease was higher than that of the control group, the difference was statistically significant (P=0.007).3. The prevalence rate of metabolic syndrome in the colorectal polyp group was higher than that of the control group, and the difference was statistically significant (P=0.010).4, the TG level of colorectal polyp group was 1.60 (1.12,2.48), higher than that of the control group (1.31 (0.96,1.91) (0.96,1.91), and the difference was statistically significant (P=0.0) (P=0.0) (P=0.0). (P=0.0), the difference has statistical significance (P=0.0). 03).5, the unconditional Logistic regression test for colorectal polyps showed that there was a positive correlation between the level of TG and the incidence of diabetes and the occurrence of colorectal polyps. The OR values were 1.290 and 3.205, respectively, P0.05.6, and the average age of the high risk adenoma group was 60.63 + 9.47, higher than the average age of the control group, which was 53.32 + 12.76. Statistical significance (P=0.005).7, the positive rate of HP in the adenomatous polyp group was higher than that of the control group, the difference was statistically significant (P=0.039).8, the high risk adenoma group and non high risk adenoma group, the HP positive rate of the left semicolon group, the right hemicolon group and the whole colon group had no statistical significance.9, the metabolic difference between the HP positive group and the HP negative group was different. No statistical significance. Conclusions: (1) metabolic syndrome is a risk factor for colorectal polyps. When these patients have the corresponding digestive system symptoms, a colorectal mirror should be considered. (2) the level of triglycerides in the metabolic syndrome and the risk factors for diabetes as a colorectal polyp, and the high risk population of colorectal polyps should be considered. Positive control of metabolic syndrome related indicators, especially glycerol three fat and blood sugar levels. (3) the age of older persons with colorectal polyps and high risk of adenoma is more likely. For older people, especially those with other risk factors, direct colonoscopy can be considered as one of the screening items. (4) the incidence of adenoma and rest in Helicobacter pylori infection The possibility of meat is large, and for HP positive patients, especially those with other risk factors, Helicobacter pylori eradication therapy can be considered. (5) there is no significant correlation between Helicobacter pylori and metabolic syndrome.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R57;R589

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