Novacek Gottfried
Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
Wien Med Wochenschr. 2006 Oct;156(19-20):527-33. doi: 10.1007/s10354-006-0346-x.
Gallstone disease is a common disorder all over the world. In the Western societies about 80 % of the gallstones are composed primarily of cholesterol. Several risk factors for gallstone formation have been identified. One of the most important risk factors is female gender. Rates of gallstones are two to three times higher among women than men. But this is primarily a phenomenon of the childbearing age. Pregnancy is also a major risk factor for gallstone formation. The risk is related to the number of pregnancies. Sex hormones are most likely to be responsible for the increased risk. Estrogen increases biliary cholesterol secretion causing cholesterol supersaturation of bile. Thus, hormone replacement therapy in postmenopausal women and oral contraceptives have also been described to be associated with an increased risk for gallstone disease. However, the effect of estrogen is dose-dependent and new oral contraceptives with a low estrogen dose do not seem to increase the rate of gallstone formation. The present article focuses on the mentioned risk factors associated with female sex hormones.
胆结石病是一种全球常见的病症。在西方社会，约80%的胆结石主要由胆固醇构成。已确定了几个胆结石形成的风险因素。其中最重要的风险因素之一是女性性别。女性胆结石发病率比男性高两到三倍。但这主要是育龄期的现象。怀孕也是胆结石形成的一个主要风险因素。风险与怀孕次数有关。性激素很可能是风险增加的原因。雌激素会增加胆汁中胆固醇的分泌，导致胆汁中胆固醇过饱和。因此，绝经后女性的激素替代疗法和口服避孕药也被认为与胆结石病风险增加有关。然而，雌激素的作用是剂量依赖性的，低雌激素剂量的新型口服避孕药似乎不会增加胆结石形成的几率。本文重点关注上述与女性性激素相关的风险因素。
