期刊文献+

胆囊结石相关危险因素的探讨 被引量:74

The risk factors of gallstones
原文传递
导出
摘要 目的探索胆囊结石发生的相关危险因素,为防治胆囊结石提供理论依据。方法回顾性分析北京协和医院2007年1月至2010年5月间体检者的临床资料,对其中的4087例胆囊结石患者(病例组)和20435例无胆囊结石体检者(对照组)按照年龄、性别进行1:5配比以作病例对照研究。对计数资料采用x2检验,计量资料采用t检验;对相关危险因素先用单因素条件Logistic回归分析方法筛选出有统计学意义的可疑危险因素,再用多因素条件Logistic回归法进行分析。结果单因素分析显示,糖尿病、收缩压、舒张压、甘油三酯、高密度脂蛋白胆固醇及体重指数6个因素在病例组与对照组之间差异有统计学意义(P〈0.05)。多因素分析证实,去除了年龄、性别的影响后,糖尿病、收缩压、高密度脂蛋白胆固醇及体重指数仍与胆囊结石显著相关,其比值(95%可信区间)分别为0.825(0.736-0.925)、0.908(0.828-0.996)、1.211(1.056~1.389)和0.746(0.691~0.805)。总胆固醇、低密度脂蛋白胆固醇在病例组与对照组间之差异无统计学意义(P〉0.05)。结论糖尿病、收缩压增高、高密度脂蛋白胆固醇降低及肥胖是胆囊结石形成的独立危险因素。因此,应该通过控制糖尿病、减轻体重、控制血压、调整血脂等措施来预防胆囊结石的发生。 Objective To determine the risk factors of gallstones. Methods A case-control study was conducted on 4087 patients with gallstones (the study group) and 20435 individuals without gallstones (the control group) at the Health Center of Peking Union Medical College Hospital (PUMCH) between January 2007 to May 2010. Using age and sex, the study and the control groups were matched in 1 : 5 ratio. Data were statistically analyzed using Chi-square test and conditional logistic regression. Results Univariate analysis showed significant differences in diabetic mellitus (DM), systolic blood pressure (SBP), diastalic blood pressure (DBP), triglyceride (TG), high density lipoprotein cholesterol (HDL-CH) and body mass index (BMI) between the study and the control groups (P〈0.05). Multivariate analysis confirmed that DM, SBP, HDL-CH and BMI were associated with gallstones, and their adjusted odds ratio (95% confidence interval) were 0. 825 (0. 736- 0. 925), 0. 908 (0. 828-0. 996), 1. 211 (1. 056-1. 389) and 0. 746 (0. 691-0. 805), respectively. The incidences of total cholesterol (TCH) and low deasity dipoprotein cholesterol (LDL-CH) were not significantly different between the two groups (P〉0.05). Conclusions DM,SBP,HDL-CH and BMI were found to be the risk factors for gallstones. To prevent gallstones, weight reduction, blood pressure control and normalization of blood lipid are important measures.
出处 《中华肝胆外科杂志》 CAS CSCD 北大核心 2011年第9期711-713,共3页 Chinese Journal of Hepatobiliary Surgery
基金 基金项目:北京市重点学科建设项目(HK100230446)
关键词 胆囊结石 危险因素 Gallstones Risk factors
  • 相关文献

参考文献13

  • 1孙传东,吴力群.胆囊结石[J].山东医药,2006,46(36):79-79. 被引量:2
  • 2Nakeeb A, Comuzzie AG, Martin L, el al. Gallstones:genetics versus environment[-J]. Ann Surg, 2002,236 : 842-849.
  • 3刘春雷,董武,王江滨.2型糖尿病与胆囊结石的相关性分析[J].中国综合临床,2007,23(5):414-416. 被引量:10
  • 4Misciagna G, Guerra V, Di Leo A, et al. Insulin and gallstones : a population case control study in southern ltaly [J]. Gut, 2000,47 : 144-147.
  • 5Guraya SY. Reappraisal of the management of cholelithiasis in diabetics[J]. Saudi Med J, 2005,26 : 1691 -1694.
  • 6Ruhl CE, Eveehart JEl. Association of diabetes, serum insulin, and C-peptide with gallbladder disease[J]. Hepatology, 2000, 31:299.
  • 7Dubrac S, Parquet M,Blouquit Y, et al. Insulin injections en- hance cholesterol gallstone incidence by changing the biliary cholesterol saturation index and apoA-1 concentration in ham- sters fed a lithogenic diet[J]. J Hepatol, 2001,35:550-557.
  • 8Scragg RKR, Calvert CD, Oliver JR. Plasma lipids and insulin in gallstone disease:a case control study[J]. Br Med J, 1984, 289:521- 525.
  • 9宗兵,艾则孜,徐继增,梅秀荣,吴荣钦,侯保国,艾尼玩,窦建忠,郜海霞,罗剑锋.新疆温宿县成年人胆囊结石患病率调查[J].中华肝胆外科杂志,2006,12(3):159-160. 被引量:13
  • 10Steppan CM, Bailey ST, Bhat S, et al. The hormone resistin links obesity esity to diabetes[J]. Nature,2001,409 :307-312.

二级参考文献41

  • 1Xiong Ding, Chang-You Lu, Ying Mei, Chang-An Liu and Yu-Jun Shi Chongqing, China Department of Hepatobiliary Surgery, Second Clinical College, Chongqing Medical University, Chongqing 400010, China.Correlation between gene expression of CCK-A receptor and emptying dysfunction of the gallbladder in patients with gallstones and diabetes mellitus[J].Hepatobiliary & Pancreatic Diseases International,2005,4(2):295-298. 被引量:20
  • 2Xiong Ding, Jian-Ping Gong, Chang-You Lu, Chang-An Liu, Yu-Jun Shi and Gen-Wu Gao Chongqing, China Department of Hepatobiliary Surgery, Second Clinical College, Chongqing University of Medical Science, Chongqing 400010, China.Relation of abnormal gallbladder arterioles to gallbladder emptying in patients with gallstone and diabetes mellitus[J].Hepatobiliary & Pancreatic Diseases International,2004,3(2):275-278. 被引量:15
  • 3施维锦.上海地区“健康人”胆石发生率的调查报告[J].中华消化杂志,1989,9(2):105-105.
  • 4吴阶平 裘法祖.黄家驷外科学(第5版)[M].北京:人民卫生出版社,2000.402.
  • 5Mantzoros CS. The role of leptin in human obesity and disease: a review of current evidence. Ann Intern Med, 1999, 130: 671-680.
  • 6Mendez-Sanchez N. Plasma Leptin and the cholesterol saturation of bile are correlated in obese women after weight loss. J Nutr, 2002,132 : 2195-2198.
  • 7Madej T, Boguski MS, Bryant SH. Threading analysis suggests that the obese gene product may be a helical eytokine. FEBS Lett,1995,373:13-18.
  • 8Sinha MK, Opentanova I, Ohannesian JP. Evidence of free and bound leptin in human circulation. Studies in lean and obese subjects and during short-term fasting. J Clin Invest, 1996,98 : 1277-1282.
  • 9Bjorbaek C, Buchholz RM, Davis SM. et al. Divergent roles of SHP-2 in ERK activation by leptin receptors. J Biol Chem, 2001,276 : 4747-4755.
  • 10Mendez Sanchez N, Bermejo-Martinez L, Chavez-Tapia NC. Obesity- related leptin receptor polymorphisms and gallstones disease. Ann Hepatol, 2006,5:97-102.

共引文献52

同被引文献539

引证文献74

二级引证文献438

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部