探讨胆囊结石的饮食相关影响因素。

本前瞻性研究对象为2015年7月至2015年9月在中山大学附属第三医院诊治的40例胆囊结石患者，设为结石组，并选取40例健康体检者作为对照组。两组均签署知情同意书，符合医学伦理学规定。对两组进行横断面调查，比较一般资料特征、体质指数、血脂、饮食中食物种类、生活习惯以及膳食摄入情况。两组正态分布数据比较采用t检验，率的比较采用χ²检验或Fisher确切概率法。

结石组文化程度以初中为主，职业以农民为主，居住地主要为农村。结石组的高密度脂蛋白胆固醇（HDL-C）为（1.1±0.3）mmol/L，明显低于对照组的（1.4±0.4）mmol/L；载脂蛋白A为（1.27±0.16）g/L，明显高于对照组的（1.09±0.27）g/L（t=-3.616，2.947；P<0.05）。结石组进食肥猪肉率为80%（32/40），明显高于对照组的35%（14/40）（χ²=8.286，P<0.05）；进食杂粮、牛奶率分别为10%（4/40）、20%（8/40），明显低于对照组的80%（32/40）、90%（36/40） （χ²=19.789，19.789；P<0.05）。两组患者在饮食口味油腻、饮食荤素搭配、饮水习惯、早餐习惯、吃饭习惯、吸烟习惯、洗手习惯以及锻炼时间方面比较差异有统计学意义（P<0.05）。结石组患者每日摄入水量、饮奶量、水果量分别为（743±379）ml、（33±4）g、（128±39）g，明显低于对照组的（1 410±406）ml、（233±88）g、（275±43）g（t=-5.373，-7.790，-3.293；P<0.05）；而摄入禽畜量、食油量分别为（112±35）、（43±12）g，明显高于对照组的（21±8）、（22±9）g（t=4.706，8.854；P<0.05）。

饮食相关知识缺乏、高脂低蛋白饮食、进餐不规律、少喝水和缺乏运动等因素可能与胆囊结石形成有关。

To investigate the diet-related influencing factors in patients with gallbladder stone.

Forty patients with gallbladder stone who were admitted to the Third Affiliated Hospital of Sun Yat-sen University between July 2015 and September 2015 were enrolled in this prospective study, as the stone group. Another 40 healthy people were selected as the control group. The informed consents of patients in two groups were obtained and the local ethical committee approval was received. A cross-sectional survey was conducted to compare the baseline data, body mass index, serum lipid level, dietary composition, living habit and dietary intake between two groups. Normally-distributed data of two groups were compared by t test, and the rates were compared by Chi-square test or Fisher's exact probability test.

A majority of patients in the stone group were farmers with junior education background, living in rural areas. The high-density lipoprotein cholesterol (HDL-C) level in the stone group was (1.1±0.3) mmol/L, significantly lower than (1.4±0.4) mmol/L in the control group (t= -3.616, P<0.05). The apolipoprotein A (apoA) level in the stone group was (1.27±0.16) g/L, significantly higher than (1.09±0.27) g/L in the control group (t=2.947, P<0.05). The percentage of eating fat pork in the stone group was 80% (32/40), significantly higher than 35% (14/40) in the control group (χ²=8.286, P<0.05). The percentage of eating cereals and dairy products in the stone group was respectively 10% (4/40) and 20% (8/40), significantly lower than 80% (32/40) and 90% (36/40) in the control group (χ²=19.789, 19.789; P<0.05). There were significant differences in the preference for fatty diet, dietary composition, drinking habit, breakfast habit, eating habit, smoking habit, hand-washing habit and exercise time between two groups (P<0.05). The daily intake of water, dairy products and fruits in the stone group was respectively (743±379) ml, (33±4) g and (128±39) g, significantly less than (1 410±406) ml, (233±88) g and (275±43) g in the control group (t=-5.373, -7.790, -3.293; P<0.05). The daily intake of poultry and edible oil in the stone group was respectively (112±35) and (43±12) g, significantly higher than (21±8) and (22±9) g in the control group (t=4.706, 8.854; P<0.05).

Lack of diet-related knowledge, high-fat and low-protein diet, irregular eating habit, insufficient drinking water and lack of exercise may probably be correlated with the incidence of gallbladder stone.