【摘要】 目的探讨胆囊结石伴血糖异常的代谢、病程特点及疾病防治的临床意义。方法 423例经超声检查明确诊断的胆囊结石患者,按空腹血糖(FPG)水平分为血糖正常组(FPG<6.1 mmol/L, 249例)及血糖异常组(FPG≥6.1 mmol/L, 174例)。统计比较两组临床指标[性别、年龄、体质量指数(BMI)、腰臀比值(WHR)、收缩压(SBP)、舒张压(DBP)]、相关代谢指标[FPG、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、尿酸(UA)],并分析两组患者病程情况。结果血糖异常组患者年龄(53.74±5.14)岁大于血糖正常组的(49.75±7.32)岁, BMI(27.25±3.65)kg/m2、WHR(0.93±0.05)、SBP(130.22±14.77)mm Hg(1 mm Hg=0.133 kPa)、DBP(84.53±8.73)mm Hg均高于对照组的(24.68±2.86)kg/m2、(0.87±0.06)、(122.75±15.71)mm Hg、(79.42±10.75)mm Hg,差异具有统计学意义(P<0.01);血糖正常组患者女性占比36.14%(90/249)高于血糖异常组的21.26%(37/174),差异具有统计学意义(P<0.01)。血糖异常组FPG、TG、TC、UA水平均明显高于血糖正常组, HDL-C水平低于血糖正常组,差异具有统计学意义(P<0.05);两组患者的LDL-C水平比较差异无统计学意义(P>0.05)。血糖异常组患者的胆囊结石病程≥5年者129例(74.1%)、病程<5年者45例(25.9%),血糖异常病程≥5年者29例(16.7%)、病程<5年者145例(83.3%)。血糖正常组患者的胆囊结石病程>10年者45例(18.1%),病程5～10年者69例(27.7%),病程<5年者135例(54.2%)。结论胆囊结石伴血糖异常的患者代谢紊乱的发生更为显著,关注胆囊结石对糖代谢的影响,或有益于糖尿病防治。更多还原

【Abstract】 Objective To discuss the metabolism, course characteristics of gallstones disease with abnormal blood glucose and the clinical significance of disease prevention and treatment. Methods A total of 423 patients with gallstone disease diagnosed by ultrasound were divided into normal blood glucose group [fasting blood glucose(FPG)<6.1 mmol/L, 249 cases] and abnormal blood glucose group(FPG≥6.1 mmol/L, 174 cases) according to FPG levels. The clinical indicators [gender, age, body mass index(BMI), waist to hip ratio(WHR), systolic blood pressure(SBP), diastolic blood pressure(DBP)], related metabolic indicators [FPG, total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), triglycerides(TG), uric acid(UA)] of the two groups were compared. The course of disease of the two groups was analyzed. Results The age(53.74±5.14) years old of abnormal blood glucose group was older than(49.75±7.32) years old of normal blood glucose group, BMI(27.25±3.65) kg/m2, WHR(0.93±0.05), SBP(130.22±14.77) mm Hg(1 mm Hg=0.133 kPa) and DBP(84.53±8.73) mm Hg were higher than(24.68±2.86) kg/m2,(0.87±0.06),(122.75±15.71) mm Hg and(79.42±10.75) mm Hg of the control group, and the difference was statistically significant(P<0.01). The proportion of female in normal blood glucose group was 36.14%(90/249), which was higher than 21.26%(37/174) in abnormal blood glucose group, and the difference was statistically significant(P<0.01). The levels of FPG, TG, TC and UA of abnormal blood glucose group were obviously higher than those of normal blood glucose group, and HDL-C was lower than that of normal blood glucose group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in LDL-C level between the two groups(P>0.05). In the abnormal blood glucose group, 129 cases(74.1%) had gallstone course≥5 years, 45 cases(25.9%) had disease course<5 years, 29 cases(16.7%) had abnormal course of blood glucose≥5 years, 145 cases(83.3%) had disease course<5 years. In the normal blood glucose group, 45 cases(18.1%) had gallstone course >10 years, 69 cases(27.7%) had disease course 5-10 years, and 135 cases(54.2%) had disease course <5 years. Conclusion The occurrence of metabolic disorders in patients with gallstones and abnormal blood glucose is more significant, and attention to the influence of gallstones on glucose metabolism may be beneficial to the prevention and treatment of diabetes mellitus.更多还原