Inkinen J, Sand J, Nordback I
Department of Surgery, Tampere University Hospital, Finland.
Hepatogastroenterology. 2000 Jul-Aug;47(34):919-21.
BACKGROUND/AIMS: The purpose of this study was to investigate the frequency of diagnosed hypothyroidism in patients with common bile duct stones.
The common bile duct stone group (Group I) consisted of all the patients who had verified gallstones in the common bile duct in endoscopic retrograde cholangiopancreatography during 1995. The control group (Group II) was matched for age, sex, and hospital admission. These patients did not have diagnosed gallbladder or common duct stones. In both groups there were 86 patients (56 women and 30 men). The median age in these groups was 73 (range: 22-92) years at the time of common bile duct stone diagnosis. Medical records of all patients were reviewed.
In Group I the prevalence of previously diagnosed hypothyroidism was 7/86 (8%) compared with 1/86 (1%) in Group II (P = 0.01). Hypothyroidism was previously diagnosed only in the common bile duct stone patients (Group I) of over 60 years of age, where the prevalence was 7/66 (11%). In addition, we studied 36 consecutive gallbladder stone patients (Group III) of over 60 years, who had no evidence of common bile duct stones. Hypothyroidism had been diagnosed in them less frequently (2/36 = 6%) than in the age and hospital admission matched common bile duct stone patients (P = 0.01). Other diagnosed endocrine disorders did not differ between the study groups.
There is a significant association between the common bile duct stones and previously diagnosed hypothyroidism. There stronger association between the common bile duct stones and hypothyroidism compared to gallbladder stones and hypothyroidism suggests a mechanism other than merely the cholesterol metabolism mediated mechanism. The 11% prevalence of previously diagnosed hypothyroidism in the common bile duct stone patients of over 60 years of age suggests all patients with common bile duct stones be screened for current thyroid dysfunction.
背景/目的：本研究旨在调查胆总管结石患者中确诊甲状腺功能减退症的发生率。
胆总管结石组（第一组）由1995年在内镜逆行胰胆管造影术中证实胆总管有胆结石的所有患者组成。对照组（第二组）在年龄、性别和入院情况方面进行匹配。这些患者未被诊断出患有胆囊或胆总管结石。两组各有86例患者（56名女性和30名男性）。在诊断胆总管结石时，这些组的中位年龄为73岁（范围：22 - 92岁）。对所有患者的病历进行了回顾。
第一组中先前确诊甲状腺功能减退症的患病率为7/86（8%），而第二组为1/86（1%）（P = 0.01）。仅在60岁以上的胆总管结石患者（第一组）中先前诊断出甲状腺功能减退症，其患病率为7/66（11%）。此外，我们研究了36例连续的60岁以上胆囊结石患者（第三组），他们没有胆总管结石的证据。与年龄和入院情况匹配的胆总管结石患者相比，他们中甲状腺功能减退症的诊断频率较低（2/36 = 6%）（P = 0.01）。各研究组之间其他诊断出的内分泌疾病无差异。
胆总管结石与先前确诊的甲状腺功能减退症之间存在显著关联。与胆囊结石和甲状腺功能减退症相比，胆总管结石与甲状腺功能减退症之间的关联更强，这表明存在一种不仅仅是胆固醇代谢介导机制的其他机制。60岁以上胆总管结石患者中先前确诊甲状腺功能减退症的患病率为11%，这表明应对所有胆总管结石患者进行当前甲状腺功能障碍的筛查。
