Wilson's病相关肝硬化患者胆囊壁增厚影响因素分析

Analysis on the influencing factors of gallbladder wall thickening in Wilson's disease-associated cirrhosis

目的探讨Wilson's病相关肝硬化患者胆囊壁增厚的影响因素。方法回顾性分析82例住院的Wilson's病相关肝硬化患者的临床资料,将患者分为3组:Wilson's病相关代偿期肝硬化组、Wilson's病相关失代偿期肝硬化组及Wilson's病不伴肝硬化组,分析其胆囊壁增厚的影响因素。结果Wilson's病患者胆囊病变常见,尤其在Wilson's病相关肝硬化患者中更常见。与Wilson's病相关代偿期肝硬化患者相比较,Wilson's病相关失代偿期肝硬化患者胆囊壁增厚(6/14比30/34,χ^(2)=25.441,P<0.01)、胆囊炎(9/14比26/35,χ^(2)=10.319,P<=0.006)与胆囊水肿(3/14比18/35,χ^(2)=9.111,P=0.017)更多见。在Wilson's病相关肝硬化患者中,病程、总胆红素、直接胆红素、血清白蛋白、胆碱酯酶、高密度脂蛋白胆固醇、胆囊壁粗糙及胆囊水肿与胆囊壁增厚显著相关。多因素分析显示门静脉内径及Child-Pugh C级是Wilson's病相关肝硬化患者胆囊壁增厚的独立危险因素。结论Wilson's病相关肝硬化患者中胆囊壁增厚常见。门静脉内径及Child-Pugh C级是Wilson's病相关肝硬化患者胆囊壁增厚的独立危险因素。

Objective To investigate influencing factors of gallbladder wall thickening in patients with Wilson's disease(WD)-associated cirrhosis.Methods A total of 82 patients with WD admitted to our hospital were retrospectively enrolled and they were divided into 3 groups:WD-associated compensated cirrhosis group,WD-associated decompensated cirrhosis group and WD without cirrhosis group.Risk factors for gallbladder wall thickening were analyzed.Results Cholecystopathy was common in patients with WD,especially in patients with WD-associated cirrhosis.Compared to the patients with WD-associated compensated cirrhosis,the rates of gallbladder wall thickening(88.23%vs 42.86%,χ^(2)=25.441,P<0.001),cholecystitis(74.29%vs 64.29%,χ^(2)=10.319,P<0.05)and hydrocholecystis(51.43%vs 21.43%,χ^(2)=9.111,P<0.05)were higher in patients with WD-associated decompensated cirrhosis.Course of disease,total bilirubin,direct bilirubin,serum albumin,cholinesterase,high-density lipoprotein-cholesterol,gallbladder wall roughness and hydrocholecystis were significantly associated with gallbladder wall thickening in patients with WD-associated cirrhosis.Multivariate analysis revealed that inside diameter of portal vein and Child-Pugh C were independently risk factors for gallbladder wall thickening in WD-associated cirrhosis.Conclusion Gallbladder wall thickening is common in patients with WD-associated cirrhosis.Inside diameter of portal vein and Child-Pugh C could be independent risk factors for the development of gallbladder wall thickening.