摘要
目的探究血脂水平与结直肠腺瘤复发的关系,以期优化结直肠腺瘤切除术后随访方案。方法回顾性分析2020年6月1日至2021年12月31日在河南省人民医院消化内科住院的313例首次接受结肠镜检查并病理诊断为结直肠腺瘤的患者,依据结肠镜随访结果分为复发组和未复发组,评估术后复发情况,比较两组患者的基线资料、血脂水平及腺瘤特征,探讨不同病理类型的结直肠腺瘤患者复发组与未复发组基线血脂水平之间是否存在差异,采用多因素Logistic回归分析结直肠腺瘤复发的危险因素。结果共纳入313例患者,其中复发117例(37.4%),未复发196例(62.6%)。HDL-C水平降低(OR=0.146,95%CI:0.049~0.436,P<0.001)、LDL-C水平升高(OR=1.560,95%CI:1.123~2.166,P=0.008)是结直肠腺瘤患者复发的独立危险因素;TG水平升高(OR=1.716,95%CI:1.176~2.504,P=0.005)、HDL-C水平降低(OR=0.173,95%CI:0.045~0.667,P=0.011)、LDL-C水平升高(OR=1.578,95%CI:1.054~2.361,P=0.027)是管状腺瘤患者复发的独立危险因素。结论HDL-C水平降低、LDL-C水平升高的结直肠腺瘤患者复发风险高,TG水平升高、HDL-C水平降低、LDL-C水平升高的管状腺瘤患者复发风险高。
Objective To explore the relationship between blood lipid level and recurrence of colorectal adenoma to optimize the follow-up plan after resection of colorectal adenoma.Methods A retrospective study was conducted on 313 patients who underwent colonoscopy and were pathologically diagnosed with colorectal adenomas in the Department of Gastroenterology,Henan Provincial People′s Hospital from Jun.1st,2020 to Dec.31st,2021.According to the results of the colonoscopy follow-up,the patients were divided into the recurrent group and non-recurrent group.The postoperative recurrence of colorectal adenoma was evaluated.The baseline data,blood lipid levels and adenoma characteristics between two groups were compared.To explore the difference in blood lipid levels between patients with different pathological types of colorectal adenoma.Multivariate Logistic regression was used to analyze the risk factors of recurrence of colorectal adenoma.Results A total of 313 patients were included,of which 117(37.4%)had recurrence and 196(62.6%)had no recurrence.Decreased HDL-C level(OR=0.146,95%CI:0.049-0.436,P<0.001)and increased LDL-C level(OR=1.560,95%CI:1.123-2.166,P=0.008)were independent risk factors for recurrence in patients with colorectal adenoma.Elevated TG level(OR=1.716,95%CI:1.176-2.504,P=0.005),decreased HDL-C level(OR=0.173,95%CI:0.045-0.667,P=0.011),and elevated LDL-C level(OR=1.578,95%CI:1.054-2.361,P=0.027)were independent risk factors for recurrence in patients with tubular adenoma.Conclusion Patients with colorectal adenoma with low HDL-C level and elevated LDL-C level are at high risk of recurrence,and patients with tubular adenoma with elevated TG level,low HDL-C level,and elevated LDL-C level are at high risk of recurrence.
作者
岳浩冉
王晶
唐金铭
郭晓阳
陈展
申小兰
曹名波
YUE Haoran;WANG Jing;TANG Jinming;GUO Xiaoyang;CHEN Zhan;SHEN Xiaolan;CAO Mingbo(Department of Gastroenterology,People′s Hospital of Zhengzhou University,Henan Provincial People′s Hospital,Zhengzhou 450000;Department of Gastroenterology,People′s Hospital of Henan University,Henan Provincial People′s Hospital,China)
出处
《胃肠病学和肝病学杂志》
2025年第9期1305-1310,共6页
Chinese Journal of Gastroenterology and Hepatology
基金
河南省医学科技攻关计划省部共建项目(SBGJ202102039)。
关键词
结直肠腺瘤
血脂
复发
Colorectal adenoma
Lipid
Recurrence
