BMC Gastroenterology:高血压与胆结石病风险之间的关联

2022-04-12 xuyihan MedSci原创

胆结石的高危人群主要有: 1、年龄大。胆结石的发病率随着年龄的增长而逐渐增高,因此在40岁以上的中老年人中更常见。 2、女性,与男性相比,女性更容易患胆固醇结石

胆结石病是指胆囊或胆管中存在胆结石的疾病。它是胆道系统的常见病,通常表现为上腹痛并伴有恶心和呕吐。胆结石病的患病率随年龄增长而增加,欧洲人群中发病率为 5.9% 至 21.9%,亚洲为4%至15%,中国为3%至11%。在胆结石病患者的一生中,超过20%的患者会出现胆道症状或并发症,需要进行手术治疗。此外,研究表明,胆结石疾病会显着增加患糖尿病、胆囊癌的风险,以及增加心血管疾病和严重急性胰腺炎等总死亡率和心脑血管特定死亡率的风险。因此,早期识别胆结石病的危险因素对于高危人群的识别和早期干预非常重要。以往的研究发现了一系列胆结石病的危险因素,为识别高危患者提供了依据。据报道,高血压与胆结石病的风险呈正相关。本研究旨在通过分析 2004 年至 2019 年超过 300,000 例接受体检的病例来调查高血压与胆结石病风险之间的关系,以提供一个相当公信力的结论。

研究人员收集的患者来自陆军军医大学健康管理中心,它是西南地区规模最大的医院之一,每年接受体检的人数超过15万人。其数据库于2006年建立,现已收录重庆、四川、贵州、云南等多个省市超过100万人的体检记录。本研究收集了中心2004年至2019年进行的体检数据,包括年龄、性别、身高、体重、血糖、血脂、腹部B超。通过腹部超声诊断胆结石病。多变量逻辑回归用于研究血压与胆结石病风险之间的关系。

 

该研究共纳入 318403 人,其中男性 171276 人(53.8%),女性 147127 人(46.2%)。其中,27463例(8.6%)超声检查确诊为胆结石病,其中胆结石12452例(3.9%),胆囊切除15017例(4.7%)。多变量逻辑回归显示,高血压与胆结石病(OR = 1.05;95% CI:1.02-1.10;P  = 0.03)和胆结石(OR = 1.12;95% CI:1.06-1.19;P  < 0.01 )风险显着相关),女性高血压与胆结石病的关联性强于男性。然而,高血压与胆囊切除术无显着相关性(OR = 0.99;95% CI:0.95-1.04;P = 0.85)。此外,结果显示,随着高血压严重程度的增加,胆结石病的风险也显着升高(P < 0.001)。

 

本项研究证实胆结石病很普遍,高血压与胆结石病风险显着相关,具有显着的剂量反应关联。该研究表明,高血压与胆囊切除术之间的关联无统计学意义,可能高血压与胆结石相关,但与需要胆囊切除术的有症状胆结石疾病无关。

原始出处:

Yalan Zhang. Et al. The association between hypertension and the risk of gallstone disease: a cross-sectional study. BMC Gastroenterology.2022.

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