胆囊结石影响胆囊癌患者恶性贫血的发生

Effect of gallbladder stones on the pernicious anemia associated with gallbladder carcinoma

目的探讨影响胆囊癌患者出现恶性贫血与胆囊结石的关系,为有效预防和控制胆囊癌相关的恶性贫血的发生提供参考.方法：回顾性分析195例胆囊癌患者资料,以是否合并胆囊结石进行分组,采用病例对照研究方法,分析胆囊结石与胆囊癌患者发生恶性贫血的关系.结果：根据胆囊癌患者是否合并癌性贫血进行分组,发现ALP、GGT、年龄、分化程度、是否伴有高血压、是否行胆囊切除术在胆囊癌患者贫血和无贫血组之间的差异有统计学意义.进一步分析胆囊癌患者合并胆囊结石对癌性贫血的影响,发现胆囊结石与癌性贫血的发生之间存在一定的联系（P〈0.001）.对上述指标行Logistic 多因素分析,结果显示胆囊结石是胆囊癌患者发生恶性贫血的独立危险因素（P=0.01）.结论：胆囊癌患者合并胆囊结石发生恶性贫血的风险高.临床上可以根据对胆囊结石的判断预防癌性贫血的发生.

Objective To investigate the relation between pernicious anemia and history of cholecystolithiasis in gallbladder cancer and provide evidence to prevent and control pernicious anemia.Methods： The clinical records of 195 patients with gallbladder cancer admitted to the Department of hepatobiliary surgery, the First Affiliated Hospital of Medical College of Xian Jiaotong University from June 2006 to June 2015 were reviewed, and divide into two group according weather having cholecystolithiasis or not. Using a case-control design, the cholecystolithiasis relevant risk of appearing pernicious anemia was analyzed. Result： After independent variable assessment by univariate analysis, multivariate Logistic regression was conducted and the results demonstrated that cholecystolithiasis was the independent risk factors for the occurrence of pernicious anemia in gallbladder cancer （P=0.01）.Conclusion： Cholecystolithiasis was the independent risk factors for the occurrence of pernicious anemia in gallbladder cancer. We can prevent anemia from gallbladder cancer by judging weather occur to gallstone.