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有症状的非复杂性胆石症患者行胆囊切除术对改善血脂状况有益吗?

Is Cholecystectomy in Patients with Symptomatic Uncomplicated Cholelithiasis Beneficial in Improving the Lipid Profile?

作者信息

Osman Adel, Ibrahim Arwa H, Alzamil Areej M, Alkhalifa Abdullah M, Badghaish Dania A, Al-Dera Faisal H, Alwosaibi Reda A

机构信息

Surgery, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Internal Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

出版信息

Cureus. 2020 Jan 21;12(1):e6729. doi: 10.7759/cureus.6729.

Abstract

Introduction Gallstone disease is an emerging health issue worldwide with its incidence on the rise. The development of gallstone disease is multifactorial, with risk factors including increased age, female sex, obesity, and the use of oral contraceptive pills. It has been established that more than 50% of patients with gallstone disease have a coexisting lipid disorder. Cholecystectomy, the definitive management of gallstones, may improve the lipid profiles of some patients. Objectives This study aims to examine the postoperative changes in the lipid profiles of patients who underwent cholecystectomy. These lipid profiles include levels of low-density lipoprotein (LDL), triglycerides (TG), high-density lipoprotein (HDL), total cholesterol (TC), and the Chol/HDL ratio. Methods This retrospective study included 55 patients who underwent cholecystectomy between 2013 and 2017. Biochemical parameters, which include LDL, TG, HDL, and TC levels, were collected using the hospital's recording system, in addition to the calculation of the Chol/HDL ratio. Results Statistically significant changes included a reduction in the mean LDL values in the two-, four-, and six-month postoperative periods (P = 0.029, 0.000, and 0.008, respectively), increased mean TG levels one-week postoperatively (P = 0.034), decreased mean TC levels at four (P = 0.049) and six months (P = 0.026) after cholecystectomy, and increased Chol/HDL ratio at two and 12 months postoperatively (P = 0.03, and 0.022, respectively). Conclusions From the results, it can be concluded that cholelithiasis is associated with abnormal lipid profiles and that undergoing cholecystectomy may improve them and reduce the future risk of developing coronary artery disease. However, further research is needed to confirm this association.

摘要

引言

胆结石疾病是一个在全球范围内日益凸显的健康问题,其发病率呈上升趋势。胆结石疾病的发展是多因素的,风险因素包括年龄增长、女性、肥胖以及口服避孕药的使用。已经确定,超过50%的胆结石疾病患者并存脂质紊乱。胆囊切除术作为胆结石的确定性治疗方法,可能会改善一些患者的脂质谱。

目的

本研究旨在检查接受胆囊切除术患者术后脂质谱的变化。这些脂质谱包括低密度脂蛋白(LDL)、甘油三酯(TG)、高密度脂蛋白(HDL)、总胆固醇(TC)水平以及胆固醇/高密度脂蛋白比值。

方法

这项回顾性研究纳入了2013年至2017年间接受胆囊切除术的55例患者。除了计算胆固醇/高密度脂蛋白比值外,还使用医院记录系统收集了包括LDL、TG、HDL和TC水平在内的生化参数。

结果

具有统计学意义的变化包括术后两个月、四个月和六个月时平均LDL值降低(P分别为0.029、0.000和0.008),术后一周平均TG水平升高(P = 0.034),胆囊切除术后四个月(P = 0.049)和六个月(P = 0.026)时平均TC水平降低,以及术后两个月和12个月时胆固醇/高密度脂蛋白比值升高(P分别为0.03和0.022)。

结论

从结果可以得出结论,胆石症与脂质谱异常有关,接受胆囊切除术可能会改善脂质谱并降低未来患冠状动脉疾病的风险。然而,需要进一步研究来证实这种关联。

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