陈莎莎 赵丽娟

【摘要】 目的：探究結直肠息肉（CRP）、结直肠癌（CRC）的发生与幽门螺杆菌（Hp）感染及CRP与血脂、尿酸（UA）的关系，为预防CRP的发生及早期预防CRC提供依据。方法：选取2018年9月-2019年12月于本院行胃镜、结肠镜和Hp检查的248例患者，收集其一般临床资料、Hp、内镜及病理结果，并依据内镜及病理结果将患者分为CRP组（n=120）、CRC组（n=28）及对照组（结肠镜检查正常，n=100）。比较三组Hp感染情况;比较CRP组与对照组的血脂、UA水平;比较CRP组中息肉不同病理类型、息肉大小、数目及部位的血脂、UA水平。结果：CRP组与CRC组Hp阳性率均高于对照组（P<0.05）;CRP组总胆固醇（TC）与甘油三酯（TG）水平均高于对照组，而高密度脂蛋白（HDL-C）水平低于对照组（P<0.05）。腺瘤性息肉TG水平高于非腺瘤性息肉（P<0.05）。CRP组中息肉不同大小、数目及部位者的各项血脂指标与UA水平比较，差异均无统计学意义（P>0.05）。结论：CRP与CRC患者Hp感染率较高。CRP患者TG、TC水平升高、HDL-L水平降低，其中腺瘤性息肉患者TG水平较高。

【关键词】 幽门螺杆菌 结直肠息肉 结直肠癌

[Abstract] Objective： To explore the relationship between the occurrence of colorectal polyp （CRP）， colorectal cancer （CRC） and the infection of Helicobacter pylori （Hp） and the relationship between CRP and blood lipid， uric acid （UA）， so as to provide evidence for the prevention of CRP and early prevention of CRC. Method： A total of 248 patients underwent gastroscopy， colonoscopy and Hp examination in our hospital from September 2018 to December 2019 were selected. Their general clinical data， Hp， endoscopy and pathological results were collected， and the patients were divided into CRP group （n=120）， CRC group （n=28） and control group （normal colonoscopy， n=100） according to endoscopy and pathological results. The infection of Hp in three groups were compared. The levels of blood lipid and UA in CRP group and the control group were compared. The levels of blood lipid and UA in different pathological types， size， number and locations of polyps in CRP group were compared. Result： The positive rates of Hp in CRP group and CRC group were higher than that in the control group （P<0.05）. The levels of total cholesterol （TC） and triglyceride （TG） in CRP group were higher than those in the control group， while the level of high-density lipoprotein （HDL-C） in CRP group was lower than that in the control group （P<0.05）. The TG level in adenomatous polyp was higher than that in non-adenomatous polyp （P<0.05）. There were no significant differences in serum lipids and UA levels among different sizes， numbers and locations of polyps in CRP group （P>0.05）. Conclusion： Hp infection rate are higher in CRP and CRC patients. The levels of TG and TC increase and the levels of HDL-L decrease in CRP patients， and the levels of TG are higher in adenomatous polyp patients.

[Key words] Helicobacter pylori Colorectal polyps Colorectal cancer

First-authors address： The Third Affiliated Hospital of Jinzhou Medical University， Jinzhou 121000， China

doi：10.3969/j.issn.1674-4985.2021.09.029

近年来，结直肠癌（colorectal cancer，CRC）的发病率逐年攀升，在我国消化系统疾病中发病率位于第2位，因其发病率及致死性高，严重影响患者的生活质量[1]。结直肠息肉（colorectal polyps，CRP）泛指肠腔内凸起的赘生物，在消化系统疾病中极为常见，为肠道干细胞凋亡、增殖、分化遭到破坏导致严重失衡的结果。结直肠腺瘤性息肉（colorectal polyps，CAP）作为CRC的癌前病变，如能进行早期筛查可明显提高CRC发现率，通过及时治疗从而降低死亡率[2]。因此，探讨CRP发生的危险因素，补充、细化符合我国国情的早期CRC筛查流程，从而筛查危险人群，对预防CRC的发生发展具有重要意义。幽门螺杆菌（Helicobacter pylori，Hp）是一种常见致病菌，有研究表明Hp与慢性胃炎、消化性溃疡、胃癌有关，并建议即使无明显症状人群发现有Hp感染后应行根除治疗[3]。近年来，随着学者的不断探索，Hp与CRP、CRC之间的关系逐渐引起学者的重视。……