肝硬化患者的胆囊结石发生率及其与肝功能分级的关系

Incidence of cholecystolithiasis in liver cirrhotic patients and its association with Child-Pugh score

目的研究肝硬化患者胆囊结石的发生率与肝功能分级的关系。方法回顾性分析195例肝硬化患者的临床资料,以同期230例健康体检者为对照组。结果肝硬化患者的胆囊结石发病率明显高于健康对照组(43.1%比6.1%,P<0.01),且胆囊结石发病率与肝功能损害程度呈正相关,Child-Pugh B级和C级患者的胆囊结石发病率显著高于A级患者(A级25.5%比B级52.4%比C级44.7%,P<0.01)。不同病因的肝硬化患者的胆囊结石发病率差异无统计学意义。胆囊结石为肝硬化患者合并急性胆囊炎、急性胰腺炎的主要原因(54.8%),经积极抗炎、利胆等对症治疗后大部分患者症状好转。结论肝硬化患者的胆囊结石发病率明显增加,并与肝脏疾病的进展呈正相关。

Objective To investigate the relationship between incidence of cholecystolithiasis and Child-Pugh score in patients with liver cirrhosis. Methods Clinical characteristics of 195 cirrhotic patients were retrospectively studied, and 230 healthy volunteers served as the control group. Results The incidence of cholecystolithiasis in liver cirrhotic patients was significantly higher than that of the control group （43. 1 % vs. 6.1%, P〈0.01）. Liver cirrhotic patients with cholecystolithiasis were positively correlated with severity of liver damage, and the incidence of cholecystolithiasis in Child-Pugh class B and class C were both higher than that of class A （class A 25.5% vs. class B 52.4% vs. class C 44. 7%, P〈0.01）. No significant difference of incidence of cholecystolithiasis was found among different causes of liver cirrhosis. Cholecystolithiasis was the main reason for acute cholecystitis and acute pancreatitis in cirrhotic patients. With prompt anti-inflammatory and cholagogue treatment, most patients have symptom alleviation. Conclusion Liver cirrhotic patients had higher incidence of cholecystolithiasis, and it was positively correlated with progression of liver disease.