【摘要】：目的:通過(guò)1:1病例-對(duì)照研究的方法,檢測(cè)結(jié)直腸癌患者的代謝相關(guān)性指標(biāo)(體重指數(shù)、高血糖、血脂異常、高血壓、高尿酸血癥、非酒精性脂肪肝、冠心病、D-二聚體、血清總膽固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白)與結(jié)直腸腺瘤、健康體檢者的差異,來(lái)探討研究各代謝指標(biāo)與結(jié)直腸癌的相關(guān)性,從而用來(lái)協(xié)助結(jié)直腸癌的早期篩查。方法:選取2014.10-2016.1在延安大學(xué)附屬醫(yī)院行相關(guān)檢查并確診為結(jié)直腸癌的患者75例為病例組,同期的結(jié)直腸腺瘤患者75例及正常體檢人群75例為對(duì)照組。根據(jù)生化檢查、影像學(xué)檢查及既往病史等資料,收集代謝相關(guān)性指標(biāo)及患者的一般情況,分析各代謝指標(biāo)與結(jié)直腸癌的相關(guān)性。結(jié)果:1.結(jié)直腸癌組與對(duì)照組(結(jié)直腸腺瘤組、正常對(duì)照組)的年齡、性別比較無(wú)統(tǒng)計(jì)學(xué)差異,而結(jié)直腸癌組患者的發(fā)病年齡集中于50~75歲之間。2.結(jié)直腸癌組的BMI、高尿酸血癥、高血壓、非酒精性脂肪肝、冠心病的患病率與對(duì)照組相比,差異無(wú)統(tǒng)計(jì)學(xué)意義。3.結(jié)直腸癌組的高血糖及血脂異常的患病率要高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義。4.與對(duì)照組相比,結(jié)直腸癌組的D-二聚體、TG水平較高,而TC、LDL-C、HDL-C較低,差異有統(tǒng)計(jì)學(xué)意義。5.經(jīng)條件Logistic回歸分析發(fā)現(xiàn)高血糖、血脂異常及D-二聚體水平與結(jié)直腸癌有相關(guān)性,是其獨(dú)立危險(xiǎn)因素。結(jié)論:結(jié)直腸癌是與代謝紊亂有關(guān)的疾病,高血糖、血脂異常、D-二聚體水平是其獨(dú)立危險(xiǎn)因素。對(duì)平均風(fēng)險(xiǎn)人群行代謝相關(guān)指標(biāo)的篩查,并結(jié)合結(jié)直腸鏡檢查,可以提高臨床結(jié)直腸癌的檢出率,從而協(xié)助我們?cè)缙陬A(yù)防、診斷及治療結(jié)直腸癌。
[Abstract]:Objective: to detect metabolic correlation indexes (body mass index, hyperglycemia, dyslipidemia, hypertension, hyperuricemia, non-alcoholic fatty liver, coronary heart disease) in colorectal cancer patients by 1:1 case-control study. In order to study the correlation between the metabolic indexes and colorectal adenoma, the differences of D-dimer, serum total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein (HDL) and colorectal adenoma were studied. This is used to facilitate early screening for colorectal cancer. Methods: 75 patients with colorectal cancer were selected as the case group, 75 patients with colorectal adenoma and 75 healthy persons as control group. According to the data of biochemical examination, imaging examination and past medical history, the correlation index of metabolism and the general situation of patients were collected, and the correlation between each metabolic index and colorectal cancer was analyzed. Results: 1. There was no significant difference in age and sex between colorectal cancer group and control group (colorectal adenoma group, normal control group), whereas the onset age of colorectal cancer patients was between 50 and 75 years old. 2. 2. The prevalence of BMI, hyperuricemia, hypertension, non-alcoholic fatty liver and coronary heart disease in colorectal cancer group was not significantly different from that in control group. The prevalence of hyperglycemia and dyslipidemia in colorectal cancer group was significantly higher than that in control group. Compared with the control group, the level of TG in colorectal cancer group was higher than that in control group, but the level of TC,LDL-C,HDL-C was lower (P < 0.05). Conditional Logistic regression analysis showed that hyperglycemia, dyslipidemia and D-dimer levels were associated with colorectal cancer and were independent risk factors. Conclusion: colorectal cancer is related to metabolic disorder, hyperglycemia, dyslipidemia and D-dimer level are independent risk factors. Screening of metabolic related indexes in the average risk population, combined with colonoscopy, can improve the detection rate of clinical colorectal cancer and help us to prevent, diagnose and treat colorectal cancer in the early stage.
【學(xué)位授予單位】：延安大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R735.34

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