双镜联合保胆取石术前后血清瘦素变化与结石复发的相关性研究

Study on the correlation between the changes of Leptin and the recurrence of calculus after double lens combination in minimally invasive gallbladder-preserving cholecystolithotomy

摘要:

目的 探究血清瘦素变化与保胆取石术后结石复发的相关性。方法 回顾性分析43例于该院住院并接受双镜联合保胆取石术的患者的临床资料，以体重指数（BMI） = 24 kg/m²为标准，分为超重组（BMI ≥ 24 kg/m²，n = 21）和正常体重组（BMI < 24 kg/m²，n = 22）；统计分析两组患者的一般情况、手术前后及术后药物干预后血清瘦素水平、手术前后血脂［血清总胆固醇（TC）、三酰甘油（TAG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）等］指标、术后结石复发情况。结果 术前：超重组TAG和LDL高于正常体重组，差异有统计学意义（P < 0.05）；超重组血清瘦素高于正常体重组，差异有统计学意义（P < 0.05）。术后：超重组TAG和LDL水平高于正常体重组，差异有统计学意义（P < 0.05）；超重组血清瘦素高于正常体重组，但差异无统计学意义（P > 0.05）。超重组术前HDL、TC、TAG和LDL等血脂水平与术后比较，差异无统计学意义（P > 0.05）；术后血清瘦素水平明显低于术前，差异有统计学意义（P < 0.05）。两组患者术后口服牛磺熊去氧胆酸胶囊6个月，超重组血清瘦素高于正常体重组，但差异无统计学意义（P > 0.05）；术后随访期间，超重组结石复发1例，正常体重组无结石复发病例，差异无统计学意义（P > 0.05）。结论 血清瘦素在双镜联合保胆取石术后明显降低，术后口服牛磺熊去氧胆酸胶囊6个月亦无明显增高，术后结石复发病例少，血清瘦素可能作为保胆取石术后结石复发的相关检测指标，对于术后结石复发的诊治具有重要意义。

Abstract:

Objective To detect the correlation between the changes of Leptin and the recurrence of calculus after double lens combination in minimally invasive gallbladder-preserving cholecystolithotomy.Methods The clinical data of 43 patients who underwent double lens combination in minimally invasive gallbladder-preserving cholecystolithotomy were retrospectively analyed. With body mass index (BMI) = 24 kg/m² as the standard, they were divided into overweight group (BMI ≥ 24 kg/m², n = 21) and normal weight group (BMI < 24 kg/m², n = 22). The general situation, serum Leptin level and serum lipid indexes [total cholesterol (TC), triacylglycerol (TAG), high density lipoprotein (HDL) and low density lipoprotein (LDL)] before and after surgery were detected in two groups, and the postoperative stone recurrence was recorded after 6 months of follow-up. And the experimental results were statistically analyzed.Results Pre-operation: TAG and LDL of overweight group were significantly higher than those in normal weight group (P < 0.05); The serum Leptin of overweight group was significantly higher than that of normal weight group (P < 0.05). Post operation: the levels of TAG and LDL in overweight group were significantly higher than those of normal body weight group (P < 0.05); The serum Leptin in overweight group was higher than that of normal weight group, but the difference was not statistically significant (P > 0.05). There were no significantly differences in the levels of HDL, TC, TAG and LDL before and after operation in overweight group (P > 0.05). The serum Leptin level after surgery was significantly lower than that before surgery (P < 0.05). After 6 months of taurosulu deoxycholic acid, the serum Leptin in overweight group was not statistically higher than that in normal weight group (P > 0.05). During postoperative follow-up, there was 1 case of recurrence of calculi in overweight group, while no case of recurrence of calculi in the normal weight group (P > 0.05).Conclusion Serum leptin decreased significantly after double lens combination in minimally invasive gallbladder-preserving cholecystolithotomy, but not increase significantly after 6 months of taurosulu deoxycholic acid, and there were few postoperative calculus recurrence cases. Serum Leptin may be used as a detection index for the recurrence of calculus after gallbladder-preserving cholecystolithotomy.