肝硬化患者并发胆囊结石的危险因素分析

Analysis of risk factors for cholecystolithiasis in patients with liver cirrhosis

目的:分析肝硬化患者并发胆囊结石的危险因素。方法:选取2020年5月至2022年5月该院收治的160例肝硬化患者进行横断面研究,其中合并胆囊结石80例(结石组),未合并胆囊结石80例(无结石组)。比较两组基础资料,并采用多因素Logistic回归分析肝硬化患者并发胆囊结石的危险因素。结果:两组患者性别、肝功能分级、肝硬化病程及血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、三酰甘油(TG)水平比较,差异无统计学意义(P>0.05);结石组年龄≥60岁、TC≥4 mmol/L、白蛋白<34 g/L、胆囊收缩素(CCK)<40 g/L、有腹水、病毒性肝硬化占比均高于无结石组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄≥60岁、病毒性肝硬化、有腹水及血清白蛋白<34 g/L、CCK<40 g/L、TC≥4 mmol/L是肝硬化患者并发胆囊结石的独立危险因素(OR>1,P<0.05)。结论:年龄≥60岁、病毒性肝硬化、有腹水及血清白蛋白<34 g/L、CCK<40 g/L、TC≥4 mmol/L是肝硬化患者胆囊结石发生的独立危险因素,临床应针对伴有这些因素的肝硬化患者予以相应干预,从而预防胆囊结石的发生。

Objective:To analyze risk factors for cholecystolithiasis in patients with liver cirrhosis.Methods:160 patients with liver cirrhosis admitted to the hospital from May 2020 to May 2022 were selected for the cross-sectional study,including 80 patients with cholecystolithiasis(cholecystolithiasis group)and 80 patients without cholecystolithiasis(non-cholecystolithiasis group).The basic data of the two groups were compared.Multivariate Logistic regression analysis was performed on the risk factors of cholecystolithiasis in these patients with liver cirrhosis.Results:There were no significant differences in gender,liver function classification and serum total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),albumin,and cholecystokinin(CCK)levels between the two groups(P>0.05).The proportions of the patients with age≥60 years old,TC≥4 mmol/L,albumin<34 g/L,CCK<40 g/L,ascites and viral cirrhosis in the cholecystolithiasis group were higher than those in the non-cholecystolithiasis group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that age≥60 years,viral cirrhosis,ascites and serum albumin<34 g/L,CCK<40 g/L,TC≥4 mmol/L were independent risk factors for cholecystolithiasis in the patients with cirrhosis(OR>1,P<0.05).Conclusions:Age≥60 years,viral cirrhosis,ascites and serum albumin<34 g/L,CCK<40 g/L,TC≥4 mmol/L are the independent risk factors for cholecystolithiasis in the patients with cirrhosis.Clinical intervention should be given to these patients based on these factors so as to prevent the occurrence of cholecystolithiasis.