摘要
目的:了解肝硬化患者胆囊结石的发生率,同时分析其影响因素及临床意义。方法:选择2014年10月至2015年8月在河南科技大学第一附属医院诊治的128例肝硬化患者为肝硬化组,并以同期门诊行体检者140例为健康对照组;其中肝硬化组根据肝功能Child-Pugh分级标准分为肝功A级(A组)、肝功B级(B组)、肝功C级(C组)。对所有研究对象进行空腹血清ALB、空腹血清CCK水平的测定。分析肝硬化胆囊结石的发生与性别、肝功能Child-Pugh分级、腹腔积液、血清ALB及CCK的关系。结果:(1)单因素分析结果显示:肝硬化组胆囊结石的发生率明显高于健康对照组(35.2%vs 8.6%,P<0.05);且随着肝功能损害程度加重,胆囊结石的发生率随之升高,即B组和C组患者的胆囊结石发生率显著高于A组患者(A组22.9%vs B组35.0%vs C组50.0%,P<0.05)。肝硬化并发腹腔积液患者的胆囊结石发生率较无腹腔积液、健康对照组明显升高(38.6%vs 22.2%vs 8.6%,P<0.05)。肝硬化组血清ALB水平较健康对照组降低(P<0.05),且随着肝功能损害程度加重而变化;而肝硬化组血清CCK水平明显高于健康对照组(P<0.05),同样随着肝功能损害程度加重而变化。肝硬化患者胆囊结石发生率无性别差异(P>0.05)。(2)多因素Logistic回归结果显示:血清ALB含量是影响肝硬化患者胆囊结石发生的重要影响因素,结果有统计学意义(P<0.05),其他影响因素无统计学意义(P>0.05)。结论 :肝硬化患者易发生胆囊结石,其发生与性别无关,而与肝功能损害程度、腹腔积液、血清ALB及CCK水平等有关,其中ALB是肝硬化患者伴胆囊结石的重要影响因素。
Objective To investigate the incidence of cholecystolithiasis in 1iver cirrhosis and analyze its＆amp;nbsp;influencing factors and clinical significance. Methods We selected 128 patients with 1iver cirrhosis who were di-agnosed and treated in the First Affiliated Hospital of Henan University of Science and Technology from Oct. 2014 to Aug. 2015 as the observation group. Meanwhile, 140 cases received medical examination served as the control group. The liver cirrhosis group were divided into class A （group A）, class B （group B）, class C （group C） ac-cording to the Child-Pugh grades. We measured the levels of fasting serum albumin （ALB） and cholecystokinin （CCK） of all subjects. The relationship of cholecystolithiasis in 1iver cirrhosis to gender, liver function Child-Pugh classification, ascites, levels of ALB and CCK was analyzed. Results （1） Univariate analysis revealed： compared with the control group, the incidence of cholecystolithiasis in 1iver cirrhosis group was higher （35.2%vs 8.6%, P〈0.05）. With increase of the degree of liver damage, the incidence of cholecystolithiasis increased. And the incidence of cholecystolithiasis in group B and group C were both higher than that of group A （group A 22.9% vs group B 35.0%vs group C 50.0%, P〈0.05）. The incidence of cholecystolithiasis in the 1iver cirrhosis group with ascites was significantly higher than that of the control group （38.6% vs 22.2% vs 8.6%, P 〈 0.05）. With increase of the degree of liver damage, the level of ALB in liver cirrhosis group decreased compared with the control group （P〈0.05）, while the level of CCK was obviously higher than that of the control group （P 〈 0.05）. The morbidity rate did not differ between the males and females with cirrhosis （P〉0.05）. （2） Multiple Logistic regression analysis re-vealed that the level of ALB is the main influencing factor （P〈0.05）. Other factors were not statistically significant. Conclusion Cholecystolithiasis frequently occurs in patients with liver cirrhosis, which has no correlation with the gender of patient, but it correlates with liver function, ascites, the levels of ALB and CCK. Among of them, the level of ALB is the main influencing factor.
出处
《实用医学杂志》
CAS
北大核心
2016年第19期3212-3215,共4页
The Journal of Practical Medicine
基金
二〇一五年度河南省医学科技攻关计划项目(编号:201504039)
关键词
肝硬化
胆囊结石
胆囊收缩素
腹水
肝功能分级
Liver cirrhosis
Cholecystolithiasis
Cholecystokinin
Ascites
Liver function score
