Wilson′s病相关肝硬化患者胆囊壁增厚影响因素分析

摘要/Abstract

摘要： 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,χ²=25.441,P<0.01)、胆囊炎(9/14比26/35,χ²=10.319,P<=0.006)与胆囊水肿(3/14比18/35,χ²=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。

关键词: Wilson′s病, 肝硬化, 胆囊壁增厚

Abstract: 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%, χ²=25.441, P<0.001), cholecystitis (74.29% vs 64.29%, χ²=10.319, P<0.05) and hydrocholecystis (51.43% vs 21.43%, χ²=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.

Key words: Wilson′s disease, Cirrhosis, Gallbladder wall thickening

李琪, 曾阿娟, 丁惠国, 李磊. Wilson′s病相关肝硬化患者胆囊壁增厚影响因素分析[J]. 肝脏, 2022, 27(5): 531-535.

LI Qi, ZENG A-juan, DING Hui-guo, LI Lei. Analysis on the influencing factors of gallbladder wall thickening in Wilson's disease-associated cirrhosis[J]. Chinese Hepatolgy, 2022, 27(5): 531-535.

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