胆汁成石趋势及成石性质多因素判断程序的研制及其临床意义

A multifactorial analysis program for the lithogenecity of bile and the type of gallstones

目的建立一胆汁成石趋势成石性质多因素判断程序，以提高判断准确性。方法运用ＶｉｓｕａｌＣ语言，编写程序。运用该程序：（１）分别对６８例和２４例胆汁进行回顾性和前瞻性判断；（２）观察利胆冲剂、胆酸钠和对照组（各２０例）服药前后的成石趋势；（３）观察利胆冲剂组（１８例）胆汁服药前后ＬＩ和ＵＣＢ％的相关性。结果（１）回顾性判断胆汁成石趋势和成石性质的敏感性为９６．７％和８３．３％，特异性为１００％和８３．８％，前瞻性判断的准确性为９５．８％和８６．９％；（２）服用利胆冲剂后胆汁的成石趋势下降；（３）服用利胆冲剂前胆汁中ＬＩ和ＵＣＢ％负相关，服药后无此现象。结论该程序判断胆汁成石趋势及成石性质的准确性较高，且具应用价值。

Objective To establish a multifactorial analysis program for the lithogenecity of blie and the type of gallstones to improve the judgment accuracy.Methods Using Visual C language to establish the program.The program is applied to(1) judge 68 bile retrospectively and 24 bile prospectively.(2)Observe the change of lithogenecity of bile of“Cholagogue Dry Syrupus',Sodium cholate and control group(20,respectively).(3)Observe the the front and rear correlation between cholesterol and bilirubin in the bile of“Cholagogue Dry Syrupus'group(18).Results (1)The sensitivity and specificity of retrospective judgment of lithogenecity are 96.7% and 100% respectively,while for the type of gallstone are 83.3% and 83.8% respectively.The accuracy of prospective judgment of lithogenecity and type of gallstone are 95.8% and 86.9% respectively.(2)The lithogenecity of bile are going down after taking “Cholagogue Dry Syrupus'while the phenomenon do not exist in the bile of Sodium cholate and control group.(3)LI and UCB% show negative correlation in the bile before thaking“Cholagogue Dry Syrupus'and no correlation after.Conclusion The program can judge the lithogenecity of bile and type of gallstone reliably and be applied satisfactorily.