胆石病易患因素的病例对照研究

A case control study on risk factors ofcholelithiasis.

分析６６例无症状胆囊结石病人胆囊壁、胆囊动力学和血清中胆汁酸、胰岛素、脂蛋白、载脂蛋白和脂质过氧化物，２４６例正常人作对照，探讨胆石病易患因素，胆石病人胆囊壁较对照组增厚（２．２６±０．５５ｍｍｖｓ２．０６±０．２９ｍｍ）．胆囊餐后体积增大（１０．９７±１０．２５ｍｌｖｓ６．５２±４．６３ｍｌ），收缩率减小（６５．１±２２．２％ｖｓ７６．ｌ±１２．２％）；血清脱氧胆酸增加（０．９５±０．８１ｕｍｏｌ／ｌｖｓ０．６８±０．７１ｕｍｏｌ／ｌ），胰岛素增加（１２．９８±７．７９ｕｕ／ｍｌｖｓｌｌ．２５±４．５２ｕｕ／ｍｌ）。其余指标均无改变。

Gallbladder wall and motility was studiedand serum componepts measured in 66 pa- tients with silent gallbladder stones(GS)com-pared with 246 controls to evaluate the risk ofdeveloping gall stones. There was no differ- ence in ideal body weight between twogroups. Using B ultrasonography ,we foundthat gallbladder wall of the patiests in GSgroup was thicker than that of control group(2.26±0.55mm vs 2.06±0. 29mm ,P<0.0l ).In comparison with control group,residual gallbladder volume of GS patients waslarge(10. 97±0. 25ml vs 6. 52± 4.63ml,P<0.0l)and the gallbladder emptying waslower(65.1±22.2%vs 76.1±12.2%,P<0.01),The concentrations of both deoxy-cholic acid and insulin in serum ot patients ofGS group increased significantly than those ofcontrol. The other serum components such aschenodeoxycholic acid, cholic acid,all of the cholestrols and triglycerides from lipopro-teins,apolipoproteins, and lipid peroxide of GSpatient were not different from those of con-trol.The results suggest that thickening ofgallbladder wall,gallbladder stasis,and the in-crease in both deoxvcholic acid and insulin inserum are risk factors for the developing ofCholelithiasis。