摘要
目的 探讨进展期大肠腺瘤性息肉(Aps)发生发展的危险因素.方法 回顾性横断面研究.选择2020年12月-2022年12月北京中医药大学深圳医院(龙岗)400例行大肠息肉切除术且病理诊断为Aps的住院患者作为观察对象,其中进展期腺瘤107例、普通腺瘤293例.收集患者一般资料(姓名、性别、年龄、BMI)、吸烟史、饮酒史、高血压病病史、糖尿病病史、13C尿素呼气试验结果,分析进展期腺瘤发病的危险因素及其证候特征.结果 ①进展期腺瘤男性患者分布[70.09％(75/107)比 57.34％(168/293),P=0.021]、年龄[(52.25±9.81)岁比(48.41±10.23)岁,P=0.001]、BMI[(24.37± 3.19)kg/m2比(23.38±3.25)kg/m2,P=0.007]高于普通腺瘤;②进展期腺瘤和普通腺瘤患者常见证型均为肠道湿热证,其中进展期腺瘤肠道湿热证患者分布高于普通腺瘤[43.0％(46/107)比32.1％(94/293);x2=4.10,P=0.043];③进展期腺瘤饮酒史患者分布高于普通腺瘤[61.7％(66/107)比39.3％(115/293);x2=15.92,P＜0.001];④进展期腺瘤糖尿病病史患者分布高于普通腺瘤[29.9％(32/107)比14.7％(43/293);x2=19.94,P＜0.001];⑤进展期腺瘤患者Hp感染率大于普通腺瘤[66.4％(71/107)比44.7％(131/293);x2=14.69,P＜0.001];⑥Logistic回归分析显示,年龄、BMI、男性、肠道湿热证、饮酒史、糖尿病病史及Hp感染是进展期腺瘤发病的危险因素(P＜0.05或P＜0.01).结论 肠道湿热证是进展期腺瘤患者的关键证候,且男性、年龄、BMI、饮酒史、糖尿病病史及Hp感染为其发病的危险因素.
Abstract
Objective To investigate the risk factors of adenomatous colorectal polyps in advanced stage.Methods Retrospective cross-sectional study.A total of 400 hospitalized patients with colorectal polypectomy and pathological diagnosis of adenomatous polyps(Aps)were selected from December 2020 to December 2022 in Shenzhen Hospital of Beijing University of Chinese Medicine(Longgang),of which 107 patients with progressive adenomas and 293 patients with common adenomas were selected.General information of patients(name,gender,age,BMI),history of smoking,alcohol consumption,history of hypertension,history of diabetes mellitus,and results of 13C urea breath test were collected to analyze the risk factors for the development of adenomas in patients with progressive adenomas and their syndromic characteristics.Results The distribution of male patients with advanced adenoma was significantly higher than that of common adenoma patients[70.09％(75/107)vs.57.34％(168/293),P=0.021],and the ages were[(52.25±9.81)years vs.(48.41±10.23)years,P=0.001],BMI[(24.37±3.19)kg/m2 vs.(23.38±3.25)kg/m2,P=0.007]significantly higher than those of ordinary adenoma patients.Intestinal damp-heat syndrome was the common witness type in both advanced and common adenomas,and the distribution of intestinal damp-heat syndrome in advanced adenomas was significantly higher than that in common adenomas[43.0％(46/107)vs.32.1％(94/293);x2=4.10,P=0.043].The distribution of patients with alcohol drinking history in advanced adenomas was significantly higher than that in common adenomas[61.7％(66/107)vs.39.3％(115/293);x2=15.92,P＜0.001].The distribution of diabetic patients with advanced adenoma was significantly higher than that of common adenoma patients[29.9％(32/107)vs.14.7％(43/293);x2=19.94,P＜0.001].The infection rate of Hp in advanced adenoma patients was significantly higher than that in common adenoma patients[66.4％(71/107)vs.44.7％(131/293);x2=14.69,P＜0.001].Logistic regression analysis showed that age,BMI,male,intestinal damp-heat syndrome,drinking history,diabetes history and Hp infection were risk factors for the development of patients with progressive adenomas(P＜0.05 or P＜0.01).Conclusion Intestinal damp-heat syndrome is the key syndrome in patients with progressive adenoma,and age,BMI,male,history of alcohol consumption,history of diabetes mellitus and Hp infection are the risk factors for its development.
基金项目
深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(LGWJ2021-75)
NETL
NSTL
万方数据