胃黄色瘤相关危险因素的分析
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摘要
目的探讨胃黄色瘤(GX)发生的可能相关危险因素。方法选取2017年1月至2018年4月于新疆医科大学第一附属医院行胃镜检查提示有GX的120例住院患者作为研究对象,随机选取同时间段内胃镜检查无GX的100例住院患者作为非黄色瘤组,比较两组的血糖、血脂水平,体质指数、幽门螺杆菌(Hp)感染情况,以及胆汁反流、萎缩、肠上皮化生、溃疡、息肉、胃黏膜慢性炎性反应、胃癌等发生率的差异。结果单因素分析结果显示黄色瘤组的糖化血红蛋白、低密度脂蛋白(LDL)水平高于非黄色瘤组(P<0.05),且黄色瘤组的Hp感染率、胃黏膜慢性炎性反应、胃黏膜萎缩、胃黏膜肠上皮化生、胃息肉、胃癌癌前病变等发生率高于非黄色瘤组(P<0.05)。对上述指标进行多因素Logistic回归分析提示LDL水平升高、Hp感染、胃黏膜慢性炎性反应、胃癌及癌前病变与GX显著相关,且为GX的独立危险因素(P<0.05)。结论 LDL偏高、Hp感染、胃黏膜慢性炎性反应、胃癌与GX的发生显著相关,且均为独立危险因素。
Objective This paper is aimed to explore the possible risk factors for gastric xanthoma. Methods One hundred and twenty hospitalized patients with xanthoma in the First Hospital Affiliated to Xinjiang Medical University from January 2017 to April 2018 were selected and assigned to the experimental group while 100 hospitalized patients without xanthoma in the gastroscopy examination in the same period were randomly selected as the control group. The blood glucose, lipid level, body mass index, incidence of helicobacter pylori infection, bile reflux, atrophy, intestinal metaplasia, ulcer, gastric polyps, chronic inflammation of gastric mucosa, gastric cancer, and early gastric cancer were compared between the two groups. Results The single factor analysis results suggest that the glycosylated hemoglobin and low density lipoprotein levels in the experimental group are higher than those in the control group(P<0.05). In addition, the incidence of helicobacter pylori infection, chronic inflammation of gastric mucosa, atrophy and intestinal metaplasia of gastric mucosa, gastric polyps, gastric cancer, and early gastric cancer in the experimental group are higher than those in the control group(P<0.05). The multivariate logistic regression analysis of the above indicators indicate that the elevated low-density lipoprotein, helicobacter pylori infection, chronic gastric mucosal inflammation, gastric cancer, and early gastric cancer are significantly correlated with gastric xanthoma, and are independent risk factors for gastric xanthoma(P<0.05). Conclusion High levels of low-density lipoprotein, helicobacter pylori infection, chronic gastric mucosal inflammation and gastric cancera are significantly associated with gastric xanthoma, which are independent risk factors for gastric xanthoma.
Objective This paper is aimed to explore the possible risk factors for gastric xanthoma. Methods One hundred and twenty hospitalized patients with xanthoma in the First Hospital Affiliated to Xinjiang Medical University from January 2017 to April 2018 were selected and assigned to the experimental group while 100 hospitalized patients without xanthoma in the gastroscopy examination in the same period were randomly selected as the control group. The blood glucose, lipid level, body mass index, incidence of helicobacter pylori infection, bile reflux, atrophy, intestinal metaplasia, ulcer, gastric polyps, chronic inflammation of gastric mucosa, gastric cancer, and early gastric cancer were compared between the two groups. Results The single factor analysis results suggest that the glycosylated hemoglobin and low density lipoprotein levels in the experimental group are higher than those in the control group(P<0.05). In addition, the incidence of helicobacter pylori infection, chronic inflammation of gastric mucosa, atrophy and intestinal metaplasia of gastric mucosa, gastric polyps, gastric cancer, and early gastric cancer in the experimental group are higher than those in the control group(P<0.05). The multivariate logistic regression analysis of the above indicators indicate that the elevated low-density lipoprotein, helicobacter pylori infection, chronic gastric mucosal inflammation, gastric cancer, and early gastric cancer are significantly correlated with gastric xanthoma, and are independent risk factors for gastric xanthoma(P<0.05). Conclusion High levels of low-density lipoprotein, helicobacter pylori infection, chronic gastric mucosal inflammation and gastric cancera are significantly associated with gastric xanthoma, which are independent risk factors for gastric xanthoma.
引文
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7 田翀,高青.胃黄斑瘤的研究进展[J].重庆医学,2017,46(19):2724-2726,2728.
8 杨宪武,杨宏伟,李红玉,等.窄带成像和美兰染色在肠上皮化生诊断中的应用价值[J].河北医药,2018,40(5):728-731.
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10 Gencosmanoglu R,Sen-Oran E,Kurtkaya-Yapicier O,et al.Xanthelasmas of the upper gastrointestinal tract[J].J Gastroenterol,2004,39(3):215-219.
11 骆元斌,顾立萍,黄小玲.胃黄色瘤30例临床病理分析[J].西部中医药,2013,26(1):119-120.
12 Chen Y,He XJ,Zhou MJ,et al.Gastric xanthelasma and metabolic disorders:a large retrospective study among Chinese population[J].World J Gastroenterol,2017,23(43):7756-7764.
13 中华医学会消化病学分会.中国慢性胃炎共识意见(2017年,上海)[J].胃肠病学,2017,22(11):670-687.
14 赵保民,赵广.胃黄色瘤是癌前病变吗?[J].中华胃肠内镜电子杂志,2014,1(2):60-63.
15 Sekikawa A,Fukui H,Maruo T,et al.Gastric xanthelasma may be a warning sign for the presence of early gastric cancer[J].J Gastroenterol Hepatol,2014,29(5):951-956.
16 Kaiserling E,Heinle H,Itabe H,et al.Lipid islands in human gastric mucosa:Morphological and immunohistochemical findings[J].Gastroenterology,1996,110(2):369-374.
17 孙爽,彭普基,李娅,等.胃黄色瘤与胃黏膜萎缩、肠化、癌变的关系[J].河南医学研究,2018,27(4):614-615.
18 Coates AG,Nostrant TT,Wilson JA,et al.Gastric xanthomatosis and cholestasis.A causal relationship[J].Dig Dis Sci,1986,31(9):925-928.
19 Bassullu N,Turkmen I,Uraz S,et al.Xanthomatous hyperplastic polyps of the stomach:clinicopathologic study of 5 patients with polypoid gastric lesions showing combined features of gastric xanthelasma and hyperplastic polyp[J].Ann Diagn Pathol,2013,17(1):72-74.
20 K?ksal A?,Suna N,Kalkan ■,et al.Is gastric xanthelasma an alarming endoscopic marker for advanced atrophic gastritis and intestinal metaplasia?[J].Dig Dis Sci,2016,61(10):2949-2955.
21 Wetzler G,Felix AA,Lipton JF.Gastric xanthelasma[J].J Pediatr Gastroenterol Nutr,2010,51(1):1.
2 Yi SY.Dyslipidemia and H.pylori in gastric xanthomatosis[J].World J Gastroenterol,2007,13(34):4598-4601.
3 Kaiserling E,Heinle H,Itabe H,et al.Lipid islands in human gastric mucosa:morphological and immunohistochemical findings[J].Gastroenterology,1996,110(2):369-374.
4 熊秋棠,陈星,王志峰,等.胃黄色瘤临床研究进展[J].中华消化内镜杂志,2017,34(8):606-608.
5 崔俊华,李懿皞,周佳烨,等.幽门螺杆菌检测方法的发展与比较[J].检验医学,2018,33(1):82-87.
6 徐玉松.胃黄色瘤与幽门螺杆菌感染的相关性分析[J].中国继续医学教育,2017,9(36):16-18.
7 田翀,高青.胃黄斑瘤的研究进展[J].重庆医学,2017,46(19):2724-2726,2728.
8 杨宪武,杨宏伟,李红玉,等.窄带成像和美兰染色在肠上皮化生诊断中的应用价值[J].河北医药,2018,40(5):728-731.
9 茆心怡,蒋建霞.胃黏膜肠上皮化生的内镜诊断及治疗进展[J].医学综述,2016,22(7):1348-1351.
10 Gencosmanoglu R,Sen-Oran E,Kurtkaya-Yapicier O,et al.Xanthelasmas of the upper gastrointestinal tract[J].J Gastroenterol,2004,39(3):215-219.
11 骆元斌,顾立萍,黄小玲.胃黄色瘤30例临床病理分析[J].西部中医药,2013,26(1):119-120.
12 Chen Y,He XJ,Zhou MJ,et al.Gastric xanthelasma and metabolic disorders:a large retrospective study among Chinese population[J].World J Gastroenterol,2017,23(43):7756-7764.
13 中华医学会消化病学分会.中国慢性胃炎共识意见(2017年,上海)[J].胃肠病学,2017,22(11):670-687.
14 赵保民,赵广.胃黄色瘤是癌前病变吗?[J].中华胃肠内镜电子杂志,2014,1(2):60-63.
15 Sekikawa A,Fukui H,Maruo T,et al.Gastric xanthelasma may be a warning sign for the presence of early gastric cancer[J].J Gastroenterol Hepatol,2014,29(5):951-956.
16 Kaiserling E,Heinle H,Itabe H,et al.Lipid islands in human gastric mucosa:Morphological and immunohistochemical findings[J].Gastroenterology,1996,110(2):369-374.
17 孙爽,彭普基,李娅,等.胃黄色瘤与胃黏膜萎缩、肠化、癌变的关系[J].河南医学研究,2018,27(4):614-615.
18 Coates AG,Nostrant TT,Wilson JA,et al.Gastric xanthomatosis and cholestasis.A causal relationship[J].Dig Dis Sci,1986,31(9):925-928.
19 Bassullu N,Turkmen I,Uraz S,et al.Xanthomatous hyperplastic polyps of the stomach:clinicopathologic study of 5 patients with polypoid gastric lesions showing combined features of gastric xanthelasma and hyperplastic polyp[J].Ann Diagn Pathol,2013,17(1):72-74.
20 K?ksal A?,Suna N,Kalkan ■,et al.Is gastric xanthelasma an alarming endoscopic marker for advanced atrophic gastritis and intestinal metaplasia?[J].Dig Dis Sci,2016,61(10):2949-2955.
21 Wetzler G,Felix AA,Lipton JF.Gastric xanthelasma[J].J Pediatr Gastroenterol Nutr,2010,51(1):1.