摘要
目的探讨乙型肝炎病毒相关慢性肝病患者合并胆囊结石(GS)的发生率及危险因素。方法收集2009年1月-2012年12月654例慢性肝病患者的住院资料,其中慢性乙型肝炎(CHB)236例、乙肝肝硬化356例,乙肝肝硬化伴肝细胞癌(HCC)62例,以同期住院的无肝脏疾病的患者(n=314)作为对照,分析各组患者GS发生率及危险因素。结果 CHB、乙肝肝硬化、乙肝肝硬化伴HCC患者的GS发生率分别为18.2%、29.2%、32.3%,均明显高于对照组(7.0%)。乙肝肝硬化及乙肝肝硬化伴HCC患者的GS发生率均明显高于CHB患者,但前两者差异无统计学意义。单变量分析显示,CHB合并GS患者的年龄、γ谷氨酰转肽酶(GGT)值及合并饮酒患者的比例均明显高于未合并GS患者;Child-pugh分级B级肝硬化患者的GS发生率明显高于A级(33.3%vs 21.5%),而C级(51.1%)的发生率明显高于B级;乙肝肝硬化合并GS患者的年龄,血清总胆红素(TBIL)、结合胆红素(DBIL)及非结合胆红素(IBIL)水平,以及合并腹水患者的比例明显高于未合并GS的患者;乙肝肝硬化伴HCC合并GS患者血清TBIL及IBIL水平明显高于未合并GS的患者。结论较大年龄、较高GGT水平及饮酒是CHB合并GS发生的独立危险或预测因素;较大年龄、较高血清TBIL水平及合并腹水是乙肝肝硬化并发GS的独立危险因素;较高血清TBIL水平是乙肝肝硬化伴HCC并发GS的独立危险因素。
Objective To investigate the incidence and risk factors for hepatitis B virus （HBV）-associated chronic liver diseases complicated with gallstones （GS）. Methods The clinical data of 654 in-patients with chronic liver diseases were collected from January 2009 to December 2012, including 236 ones with chronic hepatitis B （CHB）, 356 with HBV-associated cirrhosis, and 62 with HBV- associated cirrhosis complicated by hepatocellular carcinoma （HCC） （cirrhosis-HCC）. The hospitalized patients without liver diseases （n=314） served as the control group. The incidence and risk factors of gallstones were analyzed. Results The incidence of gallstone was higher in patients with CHB （18.2%）, HBV-associated cirrhosis （29.2%） and cirrbosis-HCC （32.3%） than in the control group （7.0%）. The incidence of gallstone was significantly higher in the cirrhosis patients and cirrhosis-HCC patients than in the CHB patients, while there was no significant difference between the former two groups. Univariate analysis revealed that the age, the serum level of gammaglutamyl transpeptidase （GGT）, and the percentage of alcohol users were older or higher in CHB patients with gallstone than those without gallstone. The incidence of gallstone was significantly higher in the cirrhotic patients with Child-Pugh B （33.3%） than in those with Child-Pugh A （21.5%）, and even higher in the patients with Child-Pugh C （51.1%） than in those with Child-Pugh B. Age, levels of total bilirubin （TBIL）, direct bilirubin （DBIL） and indirect bilirubin （IBIL）, and the percentage of ascites were higher in the cirrhosis patients with gallstone than in those without gallstone. The serum levels of TBIL and IBIL were higher in cirrhosis-HCC patients with gallstone than in those without gallstone. Conclusion Older age, higher GGT level and alcohol use are independent risk factors for gallstone in CHB. Older age, higher TBIL level and ascites are independent risk factors for gallstone in liver cirrhosis. Higher
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2014年第6期485-488,共4页
Medical Journal of Chinese People's Liberation Army
关键词
肝炎
乙型
慢性
肝硬化
癌
肝细胞
胆结石
危险因素
hepatitis B, chronic
liver cirrhosis
carcinoma, hepatocellular
cholelithiasis
risk factors
