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目的 :探讨结肠直肠癌(colorectal cancer,CRC)家族史与冠心病(coronary artery disease,CAD)患者结肠直肠肿瘤患病率的关系。方法:本研究是一项横断面调查,以首次接受冠状动脉(冠脉)血管造影且无CRC相关症状、疑诊CAD者为研究对象。根据亚太地区结肠直肠肿瘤筛查评分(Asia-Pacific colorectal screening score,APCS)对高风险者行结肠镜检查,同时测量其腰围、身高和体重。结果:总计1 157名对象参与本研究,其中54.8%(634/1 157)为高风险者,高风险者中又有91.0%(577/634)为男性吸烟者,而存在CAD的患者占81.5%(517/634)。与高风险人群中非CAD者相比,CAD患者的结肠直肠腺瘤(32.1%比22.2%,P<0.05)和进展期腺瘤(14.7%比8.6%,P<0.05)的患病率都显著升高,而CRC患病率在2组间差异则无统计学意义。剔除有一级亲属CRC家族史的83例患者后,结果显示CAD患者仅有结肠直肠腺瘤的患病率高于非CAD者(25.5%比16.0%,P<0.01)。体质量指数(body mass index,BMI)≥25与CAD患者结肠直肠腺瘤的发生相关(比值比=2.133,95%可信区间为1.219~3.730,P=0.008)。结论:即使无CRC家族史,APCS评分为高风险的CAD患者仍有较高的结肠直肠腺瘤的患病率,且其结肠直肠腺瘤的发生与CAD之间的相关性在超重(BMI≥25)患者中更明显。
Objective: To investigate the relationship between the family history of colorectal cancer (CRC) and the prevalence of colorectal cancer in patients with coronary artery disease (CAD). METHODS: This is a cross-sectional survey of patients undergoing coronary artery (coronary) angiography with no CRC-related symptoms for the first time and suspected CAD. Colonoscopy was performed on high-risk individuals based on the Asia-Pacific Colorectal Screening Score (APCS) and their waist circumference, height and weight were measured. RESULTS: A total of 1,157 participants participated in the study, 54.8% (634/1 157) of whom were at high risk, 91.0% (577/634) of men at high risk were male smokers, and patients with CAD accounted for 81.5 % (517/634). The prevalence of colorectal adenomas (32.1% versus 22.2%, P <0.05) and advanced adenomas (14.7% vs. 8.6%, P <0.05) in CAD patients was higher than in non-CAD subjects at high risk Significantly increased, while the CRC prevalence in the two groups was no significant difference. After excluding 83 patients with first-degree relatives who had a family history of CRC, the results showed that the prevalence of colorectal adenomas in CAD patients was higher than that of non-CAD patients (25.5% vs 16.0%, P <0.01). Body mass index (BMI) ≥25 was associated with the occurrence of colorectal adenomas in patients with CAD (odds ratio = 2.133, 95% confidence interval, 1.219-3.730, P = 0.008). CONCLUSION: The prevalence of colorectal adenoma is still high in CAD patients with high APCS score, even without a family history of CRC, and the association between the occurrence of colorectal adenomas and CAD is significantly greater in overweight (BMI> 25) More obvious in patients.