西藏高原地区胆囊结石危险因素分析

杨波; 侯永志; 王翔飞; 德吉; 宾业健; 白珍; 米玛

doi:10.3969/j.issn.1001-5256.2018.04.019

西藏高原地区胆囊结石危险因素分析

DOI: 10.3969/j.issn.1001-5256.2018.04.019

1. 华东疗养院物理诊断科上海援藏医疗队
2. 西藏自治区日喀则市人民医院超声科
3. 复旦大学附属中山医院心内科上海援藏医疗队

基金项目:

西藏自治区自然科学基金(2016ZR-QY-10)；

详细信息

中图分类号: R575.62
计量
- 文章访问数: 1725
- HTML全文浏览量: 14
- PDF下载量: 439
- 被引次数: 0
出版历程
- 出版日期: 2018-04-20

Risk factors for gallstones in Tibetan Plateau

Department of Medical Ultrasonics, Huadong Sanatorium, Shanghai Tibet-supporting Medical Team

Research funding:

摘要

摘要: 目的分析西藏高原地区胆囊结石的危险因素。方法研究对象为2017年4月1日-15日在日喀则市人民医院进行门诊空腹超声检查的患者254例,根据超声检查结果,将研究对象分为胆囊结石组（45例）和对照组（209例）。对全部研究对象进行问卷调查、体格检查及检查结果分析。正态分布的计量资料组间比较采用t检验,非正态分布的计量资料组间比较采用MannWhitney U检验;计数资料组间比较采用χ2检验或Fisher确切概率法;胆囊结石的危险因素分析采用logistic回归分析。结果胆囊结石组和对照组之间,年龄、饮酥油茶量、收缩压、性别、民族、文化程度、吸烟、遗传病史、HBs Ag等15个变量差异有统计学意义（P值均<0.05）。进一步采用单因素和多因素logistic回归分析,结果显示,女性[比值比（OR）=3.765,95%可信区间（95%CI）:1.7428.138]、遗传病史（OR=5.995,95%CI:1.66621.580）、文化程度较低（OR=2.907,95%CI:1.3426.295）、收...
- 胆囊结石病 /
- 危险因素 /
- 西藏[自治区]
Abstract: Objective To investigate the risk factors for gallstones in Tibetan Plateau.Methods A total of 254 patients who underwent ultrasound examination in a fasting state in Shigatse People's Hospital from April 1 to 15, 2017 were enrolled, and according to the results of ultrasound examination, these patients were divided into gallstone group with 45 patients and control group with 209 patients.A questionnaire survey, a physical examination, and a result analysis were performed for all patients.The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups; a logistic regression analysis was performed to identify risk factors for gallstones.Results There were significant differences between the gallstone group and the control group in 15 variables including age, drinking amount of Tibetan butter tea, systolic pressure, sex, ethnicity, education level, smoking, a history of inherited diseases, and HBs Ag (all P < 0.05) .The univariate and multivariate analyses showed that female sex (odds ratio [OR]= 3.765, 95% confidence interval [CI]:1.742-8.138) , a history of inherited diseases (OR = 5.995, 95% CI:1.666-21.580) , a low education level (OR = 2.907, 95% CI:1.342-6.295) , systolic pressure (OR = 1.022, 95% CI:1.004-1.041) , and drinking amount of Tibetan butter tea (OR = 1.082, 95% CI:1.007-1.163) were independent risk factors for gallstones in Tibetan Plateau (all P < 0.05) .Conclusion Sex, drinking amount of Tibetan butter tea, genetic factors, education level, and systolic pressure may be associated with the development of gallstones in Tibetan Plateau, which provides important information and clues for the prevention, early diagnosis, and treatment of gallstones in this area.
- cholecystolithiasis /
- risk factors /
- Tibet

HTML全文

参考文献(27)

[1]STINTON LM, MYERS RP, SHAFFER EA.Epidemiology of gallstones[J].Gastroenterol Clin North Am, 2010, 39 (2) :157-169.

[2]ZHANG ZW, JIANG ZY, HAN TQ, et al.Epidemiology of cholelithiasis and its risk factors[J].J Surg Concepts Pract, 2011, 16 (4) :408-412. (in Chinese) 张中文, 蒋兆彦, 韩天权, 等.胆石病的流行病学和危险因素[J].外科理论与实践, 2011, 16 (4) :408-412.

[3]LI CL, XU SZ.Ultrasonographic features of gallstones in Tibetan and Han population in plateau area[J].Chin J Ultrasound Diag, 2003, 4 (7) :526-528. (in Chinese) 李春伶, 徐书真.高原地区藏汉族人群胆囊结石的超声表现[J].中国超声诊断杂志, 2003, 4 (7) :526-528.

[4]ZHAXI CM, LI RY, JIN F, et al.Overweight, physical activity, tobacco and alcohol consumption in a cross-sectional random sample of adults of Tibeten China with gallstone disease[J/CD].Chin J Clinicians:Electronic Edition, 2011, 5 (2) :431-434. (in Chinese) 扎西措姆, 李仁勇, 金峰, 等.超重、运动、吸烟、饮酒与西藏人群胆囊结石患病风险的横断面调查研究[J/CD].中华临床医师杂志:电子版, 2011, 5 (2) :431-434.

[5]ZHAO YF, LI GH, HU MJ, et al.Epidemiological study on gallstone in Chengguan District of Lhasa City[J].Shanghai J Prev Med, 2010, 22 (12) :593-595. (in Chinese) 赵永峰, 李高辉, 胡梦杰, 等.拉萨市城关区胆结石流行病学研究[J].上海预防医学, 2010, 22 (12) :593-595.

[6]MENDEZ-SANCHEZ N, CHAVEZ-TAPIA NC, URIBE M, et al.Role of diet in cholesterol gallstone formation[J].Clin Chim Acta, 2007, 376 (1-2) :1-8.

[7]SHAFFER EA.Gallstone disease:epidemiology of gallbladder stone disease[J].Best Pract Res Clin Gastroenterol, 2006, 20 (6) :981-996.

[8]TSAI CJ, LEITZMANN MF, WILLETT WC, et al.Macronutrients and insulin resistance in cholesterol gallstone disease[J].Am J Gastroenterol, 2008, 103 (11) :2932-2939.

[9]MA GS, KONG LZ, LUAN DC, et al.The descriptive analysis of the smoking pattern of people in China[J].Chin J Prev Contr Chron Non-commun Dis, 2005, 13 (5) :195-199. (in Chinese) 马冠生, 孔灵芝, 栾德春, 等.中国居民吸烟行为的现状分析[J].中国慢性病预防与控制, 2005, 13 (5) :195-199.

[10]MO LF.Definition of habit of student physical training[J].J Jianghan Univ:Natural Sci, 2007, 35 (1) :91-93. (in Chinese) 莫莲芳.对大学生体育锻炼习惯概念的界定[J].江汉大学学报:自然科学版, 2007, 35 (1) :91-93.

[11]SUOLANG YZ, LI YP, ZHANG LL, et al.Analysis of disease composition of in patients from 2014 to 2015 in Tibet Autonomous Region People's Hospital[J].Chin J Evid-based Med, 2017, 17 (3) :255-261. (in Chinese) 索朗央宗, 李幼平, 张伶俐, 等.西藏自治区人民医院2014~2015年住院患者疾病构成分析[J].中国循证医学杂志, 2017, 17 (3) :255-261.

[12]ZENG YP, WEN YS, MENG Y, et al.Analysis of disease spectrum in patients from Tibet to Chengdu[J].West China Med J, 2015, 30 (2) :323-325. (in Chinese) 曾以萍, 文永思, 蒙毅, 等.西藏到成都就诊患者疾病谱分析[J].华西医学, 2015, 30 (2) :323-325.

[13]LAMMERT F, GURUSAMY K, KO CW, et al.Gallstones[J].Nat Rev Dis Prim, 2016, 2:16024.

[14]VOLZKE H, BAUMEISTER SE, ALTE D, et al.Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence[J].Digestion, 2005, 71 (2) :97-105.

[15]ZHOU BB, WANG XM, ZHANG Q, et al.Association between metabolic syndrome and gallstones[J].J Clin Hepatol, 2017, 33 (5) :880-882. (in Chinese) 周冰冰, 王学梅, 张茜, 等.代谢综合征与胆囊结石的相关性分析[J].临床肝胆病杂志, 2017, 33 (5) :880-882.

[16]LIAO XM, WANG XH, XIONG ZY, et al.Cross-sectional survey of diet-related influencing factors in patients with gallbladder stone[J/CD].Chin J Hepatic Surg:Electronic Edition, 2016, 5 (6) :398-403. (in Chinese) 廖雪梅, 王雪华, 熊志勇, 等.胆囊结石饮食相关影响因素的横断面调查[J/CD].中华肝脏外科手术学电子杂志, 2016, 5 (6) :398-403.

[17]CHEN XG, LIU JQ, PENG MH, et al.Changes in cholelithiasis in Guangxi during the past 19 years[J].Chin J Hepatobiliary Surg, 2001, 7 (5) :262-265. (in Chinese) 陈希纲, 刘家奇, 彭民浩, 等.广西胆石病的19年变迁[J].中华肝胆外科杂志, 2001, 7 (5) :262-265.

[18]ZHU DM, CHEN Y, XU XH, et al.An epidemic survey of gallbladder disease in Hefei district[J].Chin J Gen Surg, 2002, 17 (5) :271-272. (in Chinese) 朱丹木, 陈怡, 许晓红, 等.合肥地区胆囊疾病的流行病学调查[J].中华普通外科杂志, 2002, 17 (5) :271-272.

[19]HU AH, AO XL, YU JJ, et al.Optimization of industrialization process of traditional Yak Butter-tea[J].Food Fermentation Industries, 2016, 42 (3) :131-136. (in Chinese) 胡爱华, 敖晓琳, 余佳佳, 等.传统酥油茶工业化加工中重要工艺参数的优化[J].食品与发酵工业, 2016, 42 (3) :131-136.

[20]XU M, DU JC, YU SF, et al.Research on the process of Tibet Buttered tea[J].Food Res Develop, 2015, 36 (18) :72-75. (in Chinese) 徐敏, 杜金城, 于上富, 等.藏式酥油茶生产工艺研究[J].食品研究与开发, 2015, 36 (18) :72-75.

[21]JIANG ZY, HAN TQ, ZHANG SD.The current understanding of the pathogenesis of cholecystolithiasis[J].J Abdominal Surg, 2010, 23 (5) :264-265. (in Chinese) 蒋兆彦, 韩天权, 张圣道.胆囊结石发病机制的当前认识[J].腹部外科, 2010, 23 (5) :264-265.

[22]KATSIKA D, GRJIBOVSKI A, EINARSSON C, et al.Genetic and environmental influences on symptomatic gallstone disease:a Swedish study of 43411 twin pairs[J].Hepatology, 2005, 41 (5) :1138-1143.

[23]MENDEZ-SANCHEZ N, KING-MARTINEZ AC, RAMOS MH, et al.The Amerindian's genes in the Mexican population are associated with development of gallstone disease[J].Am J Gastroenterol, 2004, 99 (11) :2166-2170.

[24]BUCH S, SCHAFMAYER C, VOLZKE H, et al.A genome-wide association scan identifies the hepatic cholesterol transporter ABCG8as a susceptibility factor for human gallstone disease[J].Nat Genet, 2007, 39 (8) :995-999.

[25]BUCH S, SCHAFMAYER C, VOLZKE H, et al.Loci from a genome-wide analysis of bilirubin levels are associated with gallstone risk and composition[J].Gastroenterology, 2010, 139 (6) :1942-1951.

[26]HU YS, YAO CH, WANG ZW, et al.Survey on the prevalence of hypertension in different ethnic groups in China in 2002[J].J Hygiene Res, 2006, 35 (5) :573-575. (in Chinese) 胡以松, 姚崇华, 王志文, 等.2002年中国部分民族高血压患病情况[J].卫生研究, 2006, 35 (5) :573-575.

[27]YIN DS.Analysis of drinking of Tibetan butter tea as independent risk factor for hypertension in Tibet[J].Xinxueguanbing Fangzhi Zhishi, 2013, 1:8-10. (in Chinese) 尹代双.饮用酥油茶作为藏区高血压独立危险因素的探讨[J].心血管病防治知识, 2013, 1:8-10.

施引文献

资源附件(0)

访问统计