乙型病毒性肝炎与胆结石患病率的分层抽样病因学队列研究

Cohort study on relationship between hepatitis B and gallstones using stratified sampling

目的 从流行病学调查入手 ,分析病毒性肝炎与胆石症之间的因果关系。方法 统计本院 1998年 1月至 2 0 0 1年 6月确诊的乙型肝炎住院病人 5 10例 ,与同一时期非乙肝病人 35 98例做对照。将乙型肝炎 (乙肝 )患者分层为组 ,分别调查各组胆结石症的患病率 ,将资料按队列研究的设计 ,计算患胆石症的相对危险度RR ,做组间RR的显著性检验 (U检验 )。结果 提示与对照组比较 ,乙肝患者中的慢性肝炎 ,肝硬化的患者 ,RR值显著升高 ,差异有非常显著性 (P <0 .0 1) ,急性肝炎和瘀胆型肝炎RR值升高不显著。乙肝患者经长期服用中药 ,可使胆石症的患病率降低。结论 研究提示胆石症的病因之一是乙肝的慢性病变改变 ,从而为胆石症的防治提供了流行病学的理论依据。

Objective To investigate the relationship between hepatitis B and gallstones using epidemiological methods. Methods The analysed data from 510 patients with hepatitis B and 359 patients with other diseases treated in our hospital from the period January 1998 to June 2001 were retrospectively analysed.The patients with hepatitis B were classified into groups.The incidence of gall,stones was determined in each group.Queue study method was used to calculate RR in each group and statistical analysis was conducted to determine difference among different groups. Results As compared the patients gall,stone with the patients with other disases, RR in those with hepatitis B (including those with chronic hepatitis or liver cirrhosis) was significantly higher ( P <0.01). The value of RR was not markedly increased in patients with acute hepatitis or cholestatic hepatitis. After long term administration of Chinese herbal medicine, the incidence of gallstones in patients with hepatitis B was decreased. Conclusion Chronic pathological changes in patients with hepatitis B may be one of the causes for gallstones.This may provide epidemiological basis for prevention and treatment of gallstones.