大学教师胆结石患病现状及危险因素的多中心研究

张弛; 胡舒铃; 孙鹏; 白烨; 王宇彤; 张本; 谷冬晴; 王新

doi:10.3969/j.issn.1001-5256.2020.03.031

大学教师胆结石患病现状及危险因素的多中心研究

DOI: 10.3969/j.issn.1001-5256.2020.03.031

1. 天津医科大学肿瘤医院预防科国家肿瘤临床医学研究中心天津市“肿瘤防治”重点实验室天津市恶性肿瘤临床医学研究中心
2. 陆军军医大学第一附属医院流行病学中心
3. 哈尔滨医科大学第二附属医院普外科
4. 国家癌症中心中国医学科学院肿瘤医院结直肠外科
5. 重庆医科大学公共卫生学院流行病与卫生统计科

基金项目:

国家自然科学基金项目(81673255,81874283,81903393,81903398)；国家“千人计划”青年项目；陆军军医大学临床医学科研人才培养计划(2018XLC1004);陆军军医大学拔尖人才培养计划基金(SWH2018BJKJ-12);陆军军医大学第一附属医院重大领域技术创新计划(SWH2016ZDCX1012)；重庆市自然科学基金面上项目(cstc2019jcyj-msxm X0466)；

详细信息

中图分类号: R575.62
计量
- 文章访问数: 1113
- HTML全文浏览量: 59
- PDF下载量: 260
- 被引次数: 23
出版历程
- 收稿日期: 2019-09-12
- 出版日期: 2020-03-20

Prevalence of gallstones among university teachers and related risk factors: A multicenter study

National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin Clinical Research Center for Cancer,Department of Prevention,Tianjin Medical University Cancer Institute and Hospital

Research funding:

摘要

摘要: 目的研究天津市大学教师胆结石的患病率及其危险因素。方法收集2015年在天津医科大学肿瘤医院健康体检中心参加体检的五所高校教师的体检数据,采用腹部超声对胆结石进行诊断。计数资料组间比较采用χ~2检验。采用单因素及多因素logistic回归法分析不同大学胆结石患病的独立危险因素,并采用Meta分析的方法对不同大学教师患病率及危险因素进行合并。结果共纳入大学教师8006人,其中440人被诊断为胆结石,合并后胆结石患病率为5. 5%。Meta分析结果显示,高血压[比值比(OR)=1. 67,95%可信区间(95%CI):1. 32～2. 12,P <0. 001]、脂肪肝(OR=1. 39,95%CI:1. 12～1. 72,P <0. 001)、肾结石(OR=1. 90,95%CI:1. 15～3. 14,P=0. 01)、较高水平的己糖激酶(OR=1. 42,95%CI:1. 03～1. 94,P=0. 03)、较高水平的ALT(OR=1. 32,95%CI:1. 01～1. 73,P=0. 04)和高球蛋白水平(OR=1. 74,95%CI:1. 08～2. 79,P=0. ...
- 胆结石 /
- 危险因素 /
- 高校教师 /
- 多中心研究(主题)
Abstract: Objective To investigate the prevalence rate of gallstones among university teachers in Tianjin,China,and related risk factors.Methods Physical examination data were collected from the teachers from five universities who participated in physical examination in Physical Examination Center,Tianjin Medical University Cancer Institute and Hospital,in 2015,and abdominal ultrasound was used for the diagnosis of gallstones. The chi-square test was used for comparison of categorical data between groups. Univariate and multivariate logistic regression analyses were used to identify the risk factors for gallstones in the teachers from different universities,and a meta-analysis was used for the pooled analysis of prevalence rate and risk factors. Results A total of 8006 university teachers were enrolled,among whom 440 were diagnosed with gallstones,and the pooled prevalence rate of gallstones was 5. 5%. The meta-analysis showed that hypertension( odds ratio[OR]= 1. 67,95% confidence interval [CI]: 1. 32-2. 12,P <0. 001),fatty liver( OR =1. 39,95% CI: 1. 12-1. 72,P < 0. 001),kidney stones( OR = 1. 90,95% CI: 1. 15-3. 14,P = 0. 01),and high levels of hexokinase( OR = 1. 42,95% CI: 1. 03-1. 94,P = 0. 03),alanine aminotransferase( OR = 1. 32,95% CI: 1. 01-1. 73,P = 0. 04),and globulin( OR = 1. 74,95% CI: 1. 08-2. 79,P = 0. 02) were risk factors for gallstones. Conclusion There is a relatively low prevalence rate of gallstones among university teachers in Tianjin,and hypertension,fatty liver,kidney stones,and high levels of hexokinase,alanine aminotransferase,and globulin may be the risk factors for gallstones.
- cholelithiasis /
- risk factors /
- college teachers /
- multicenter studies as topic

HTML全文

参考文献(34)

[1] STINTON LM,SHAFFER EA. Epidemiology of gallbladder disease:Cholelithiasis and cancer[J]. Gut Liver,2012,6(2):172-187.

[2] CHEN CH,HUANG MH,YANG JC,et al. Prevalence and risk factors of gallstone disease in an adult population of Taiwan:An epidemiological survey[J]. J Gastroenterol Hepatol,2006,21(11):1737-1743.

[3] ANSARI-MOGHADDAM A,KHORRAM A,MIRI-BONJAR M,et al. The prevalence and risk factors of gallstone among adults in south-east of Iran:A population-based study[J].Glob J Health Sci,2015,8(4):60-67.

[4] ZENG Q,HE Y,QIANG DC,et al. Prevalence and epidemiological pattern of gallstones in urban residents in China[J].Eur J Gastroenterol Hepatol,2012,24(12):1459-1460.

[5] WANG F,WANG J,LI Y,et al. Gallstone disease and type 2diabetes risk:A mendelian randomization study[J]. Hepatology,2019,70(2):610-620.

[6] CHANG Y,NOH YH,SUH BS,et al. Bidirectional association between nonalcoholic fatty liver disease and gallstone disease:A cohort study[J]. J Clin Med,2018,7(11):e458.

[7] KIU KT,CHEN HL,HUANG MT,et al. Outcome analysis of patients with gallstone disease receiving cholecystectomy:A population-based cohort study[J]. Digestion,2017,95(2):132-139.

[8] BORNMAN PC,BECKINGHAM IJ. ABC of diseases of liver,pancreas,and biliary system[J]. BMJ,2001,322(7284):477-480.

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

[10] LIU HC,CHEN WL,XIAO CL,et al. Prevalence of cholelithiasis and associated risk factors among adult population in Jiujiang[J]. Jiangxi Med J,2015,50(12):1342-1344.(in Chinese)刘合春，陈伟力，肖传玲，等．九江地区成人胆石病患病率及危险因素的流行病学调查[J]．江西医药，2015,50(12):1342-1344.

[11] WANG YC,ZHANG WL,WANG XH. A review of the risk factors for cholelithiasis in China[J]. Chin J Mult Organ Dis Elderly,2018,17(8):636-640.(in Chinese)王云超，张维璐，王新华．我国胆石病相关危险因素概述[J]．中华老年多器官疾病杂志，2018,17(8):636-640.

[12] ZHAN L,PAN YZ,CHRN L,et al. Prevalence of ABCB4 polymorphisms in gallstone disease in han-Chinese population[J]. Am J Transl Res,2016,8(2):1218-1227.

[13] DAVIDE F,ADA D,SIMONA C,et al. Incidence of gallstone disease in Italy:Results from a multicenter, populationbased Italian study(the MICOL project)[J]. World J Gastroenterol,2008,14(34):5282-5289.

[14] HOU L,SHU XO,GAO YT,et al. Anthropometric measurements,physical activity,and the risk of symptomatic gallstone disease in Chinese women[J]. Ann Epidemiol,2009,19(5):344-350.

[15] BEHARI A,KAPOOR VK. Asymptomatic gallstones(As GS)-To treat or not to?[J]. Indian J Surg,2012,74(1):4-12.

[16] CHEN JY,HSU CT,LIU JH,et al. Clinical predictors of incident gallstone disease in a Chinese population in Taipei,Taiwan[J]. BMC Gastroenterol,2014,14(1):83.

[17] WANG QH,ZHANG ZW,WU J,et al. Epidemiology of gallbladder stone disease in Shanghai[J]. J Surg Concepts Pract,2018,23(3):252-257.(in Chinese)王启晗，张中文，吴健，等．上海地区胆囊结石病的流行病学调查[J]．外科理论与实践，2018,23(3):252-257.

[18] CHEN M,ZHANG T,KELI M,et al. Analysis on prevalence and characteristics factors of gallstone in Han and Uygur populations[J/CD]. Chin J Clinicians(Electronic Edition),2015,9(8):66-72.(in Chinese)陈敏，张涛，克力木，等．维吾尔族和汉族胆囊结石患病现状及特点分析[J/CD]．中华临床医师杂志(电子版)，2015,9(8):66-72.

[19] FIGUEIREDO JC,HAIMAN C,PORCEL J,et al. Sex and ethnic/racial-specific risk factors for gallbladder disease[J].BMC Gastroenterol,2017,17(1):153.

[20] LIANG Y,SHI MC,XIE XL,et al. Analysis of the incidence rate of biliary stone in patients with different age[J]. Med J Natl Defending Forces Southwest China,2003,13(2):227-228.(in Chinese)梁酉，石梅初，谢晓玲，等．不同年龄人群胆结石患病率的对比调查分析[J]．西南国防医药，2003,13(2):227-228.

[21] YU QH,SHEN JZ. Changes of serum leptin and lipoprotein levels in patients with cholecystolithiasis and hypertension[J].Lab Med,2009,24(12):914-915.(in Chinese)俞勤华，沈建忠．胆囊结石合并高血压患者血清瘦素和脂蛋白水平的变化[J]．检验医学，2009,24(12):914-915.

[22] SUN WJ,ZHAO XS,SU XL. Current understanding of the complex roles of Leptin in regulation of blood pressure[J].Chin J Cardiovasc Med,2013,18(3):71-74.(in Chinese)孙文锦，赵兴胜，苏秀兰．瘦素与血压调节关系的研究进展[J]．中国心血管杂志，2013,18(3):71-74.

[23] LI J,WEI XG,LU QM,et al. Research advances in association between diseases outside the gallbladder and gallstones[J]. J Clin Hepatol,2016,32(5):1018-1021.(in Chinese)李娟，魏小果，卢启明，等．胆外疾病与胆囊结石相关性的研究进展[J]．临床肝胆病杂志，2016,32(5):1018-1021.

[24] HYOGO H,ROY S,PAIGEN B,et al. Leptin promotes biliary cholesterol elimination during weight loss in ob/ob mice by regulating the enterohepatic circulation of bile salts[J]. J Biol Chem,277(37):34117-34124.

[25] ZENG DF,LIU H,QUE RL,et al. Clinical application of glycocholic acid in evaluating liver function damage of gallstones[J]. J Nantong Univ(Med Sci),2017,37(4):353-356.(in Chinese)曾德飞，刘辉，阙荣良，等．甘胆酸在评价胆囊结石肝功能损害中的临床应用[J]．南通大学学报(医学版)，2017,37(4):353-356.

[26] SHEN SS,GONG JJ,WANG XW,et al. Promotional effect of nonalcoholic fatty liver disease on gallstone disease:A systematic review and meta-analysis[J]. Turk J Gastroenterol,2017,28(1):31-39.

[27] WU JP. Analysis of pathogenesis and factors of fatty liver and gallstone[J]. J World Latest Med Inf,2016,16(81):51.(in Chinese)吴建平．脂肪肝与胆结石的发病机制与发病因素的分析[J]．世界最新医学信息文摘，2016,16(81):51.

[28] MENDEZ-SANCHEZ N,BERMEJO-MARTINEZ LB,VINALS Y,et al. Serum leptin levels and insulin resistance are associated with gallstone disease in overweight subjects[J]. World J Gastroenterol,2005,11(39):6182-6187.

[29] KATSIKA D,TUVBLAD C,EINARSSON C,et al. Body mass index,alcohol,tobacco and symptomatic gallstone disease:A Swedish twin study[J]. J Intern Med,2007,262(5):581-587.

[30] YANG XX,HUANG CB,WU YY. A study on the relation between immunoglobulins and cholesterol gallstone formation[J]. J Gannan Med Uni,2004,24(5):570-571.(in Chinese)杨小燕，黄承斌，吴泳泳．免疫球蛋白与胆囊胆固醇结石形成的关系[J]．赣南医学院学报，2004,24(5):570-571.

[31] SUI GD. Studies on the effect between immunoglobulin and cholesterol gallstone formation[J]. Chin J Clin Gastroenterol,2002,14(5):195-197.(in Chinese)隋国德．免疫球蛋白在胆囊胆固醇结石形成中的作用研究[J]．临床消化病杂志，2002,14(5):195-197.

[32] SHU Y,XIAO LJ. Research progress of prokaryote and anti nucleation factors in bile[J]. Foreign Med Sci:Digive System Dis,1996,1:21-23.(in Chinese)舒晔，肖路加．胆汁中促成核及抗成核因子的研究进展[J]．国外医学:消化系疾病分册，1996,1:21-23.

[33] KIM SY,SONG CM,LIM H,et al. Bidirectional association between gallstones and renal stones:Two longitudinal followup studies using a national sample cohort[J]. Sci Rep,2019,9(1):2620.

[34] SAKHAEE K. Recent advances in the pathophysiology of nephrolithiasis[J]. Kidney Int,2009,75(6):585-595.

施引文献

期刊类型引用(20)

1.	秦鹏，李树森，刘皓，吴广迎. 胃冠状静脉栓塞术在门脉高压性上消化道出血经颈静脉肝内门腔静脉分流术患者中的临床疗效. 血管与腔内血管外科杂志. 2022(09): 1130-1134 . 百度学术
2.	高绍，王宏亮，聂春晖，张岳林，周坦洋，余子牛，杨月，孙军辉. 对比TIPS联合胃冠状静脉栓塞术与单独TIPS治疗肝硬化门静脉高压伴上消化道出血的中远期疗效：Meta分析. 中国介入影像与治疗学. 2022(11): 673-677 . 百度学术
3.	张大维，吴东辉，孙兴安. TIPS对肝硬化并发上消化道出血患者近期肝肾功能和远期疗效的影响. 当代医学. 2021(35): 129-130 . 百度学术
4.	林纲毅，马洺远，蔡宗洋. 超声引导下门静脉穿刺导引经颈静脉肝内门体分流术联合曲张静脉栓塞治疗食管胃底静脉曲张破裂出血的临床效果. 中国当代医药. 2020(07): 113-116 . 百度学术
5.	王宁，林芳明，吕明. TIPS联合GCVE用于门静脉高压并发上消化道大出血的应用价值. 肝脏. 2020(09): 952-954 . 百度学术
6.	韩志强. 肝硬化上消化道出血37例外科临床治疗效果观察. 世界最新医学信息文摘. 2019(05): 95+102 . 百度学术
7.	张明礼. PTVE联合PSE治疗肝硬化门脉高压并上消化道出血的观察. 实用中西医结合临床. 2019(05): 24-26 . 百度学术
8.	孙允涛. 肝硬化门静脉高压并发上消化道出血的相关危险因素分析. 中国民康医学. 2019(10): 81-83 . 百度学术
9.	孙巧玉，赖雪珍，河源媛. 门脉高压合并上消化道出血采用PTVE联合PSE手术的效果分析. 现代消化及介入诊疗. 2019(08): 837-841+846 . 百度学术
10.	杨荣焕. TIPS和PTVE介入方法治疗肝硬化门静脉高压引起的上消化道出血的优劣差异. 黑龙江医学. 2019(09): 1012-1013+1016 . 百度学术
11.	武和平. 不同介入途径胃冠状静脉栓塞术治疗肝硬化门静脉高压出血的临床疗效观察. 现代消化及介入诊疗. 2018(02): 208-210 . 百度学术
12.	李广忠. 分析肝硬化门脉高压症下食管静脉曲张破裂出血的危险因素. 智慧健康. 2018(07): 91-92+126 . 百度学术
13.	李贤圣，董勤勇，张乐，夏侨，贺军. 经颈静脉门静脉分流术介入治疗门静脉高压引起上消化道出血的疗效分析. 浙江创伤外科. 2018(02): 272-273 . 百度学术
14.	赵晓飞，林栋栋，李宁，臧运金，郭庆良，武聚山. 门静脉高压患者脾切断流术后曲张静脉再出血的危险因素分析. 临床肝胆病杂志. 2018(10): 2182-2185 . 本站查看
15.	吴笋. 经颈静脉肝内门体静脉分流术加胃冠状静脉栓塞术治疗门脉高压症初探. 现代医用影像学. 2018(05): 1522-1523+1528 . 百度学术
16.	田广俊，池晓玲，常钢，孟凡喆，曹敏玲，黎英贤，徐浩祥，梁宏才，赵朋涛，吴晓菊，萧焕明. 中药灌肠防治TIPS治疗肝硬化门静脉高压伴上消化道出血术后肝性脑病临床观察. 新中医. 2018(12): 87-91 . 百度学术
17.	樊春燕，叶晓丽，戴晓婷，吴宇清. 肝硬化门静脉高压并发上消化道出血的相关性分析研究. 血管与腔内血管外科杂志. 2018(05): 381-385 . 百度学术
18.	彭虹. 肝硬化门静脉高压并发上消化道出血的相关危险因素分析. 中国继续医学教育. 2017(31): 58-59 . 百度学术
19.	张志勇. 不同手术方案治疗肝硬化门脉高压症的临床对比. 临床医药文献电子杂志. 2017(46): 8924-8925 . 百度学术
20.	向平，张川，张亮科，唐瑞强，叶继彬. 1例上消化道出血病人护理体会. 世界最新医学信息文摘. 2016(14): 247 . 百度学术