Hopper K D, Landis J R, Meilstrup J W, McCauslin M A, Sechtin A G
Department of Radiology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
Invest Radiol. 1991 Nov;26(11):939-45. doi: 10.1097/00004424-199111000-00004.
The gallbladder and biliary system were scanned by real-time ultrasound in 2274 patients undergoing diagnostic ultrasound for other than gallbladder disease. Patients (212) with previous gallbladder symptoms or with nonvisualization of their gallbladder were excluded from the study. Obesity is the most important risk factor for the development of asymptomatic gallstones in women (P less than .01), although it is not a significant factor in men. Increasing age is an important risk factor for both sexes, and the only significant risk factor in men (P less than .01). While few men have asymptomatic gallstones before the age of 40, 5% of women aged 20-29 and 9% aged 30-39 do. In the 40 and over age group, men (14%) and women (11%) had insignificantly different prevalences. In women, the number of previous pregnancies is a significant risk factor (chi-square = 5.4, P = .02). For instance, there is a 3%, 8%, and 17% overall frequency of gallstones in women with 0, 3, and 6 or more previous pregnancies, respectively. A stepwise logistic regression analysis, after adjusting for age, body mass index, and for women, number of pregnancies, found no significant increased risk related to race (P = .40), high blood pressure (P = .43), heart disease (P = .47), or diabetes (P = .46). After age adjustment, there is no significant gender effect (P = .25). Asymptomatic gallstones are a relatively common occurrence in men over 40 and women over 30. While age is the only significant risk factor in men, obesity, parity, and to a lesser extent age were significant risk factors in women.
对2274例因非胆囊疾病接受诊断性超声检查的患者进行了实时超声检查胆囊和胆道系统。有既往胆囊症状或胆囊未显影的患者（212例）被排除在研究之外。肥胖是女性无症状胆结石形成的最重要危险因素（P<0.01），尽管在男性中它不是一个显著因素。年龄增长对男女都是重要的危险因素，且是男性唯一的显著危险因素（P<0.01）。40岁之前很少有男性有无症状胆结石，而20 - 29岁的女性中有5%、30 - 39岁的女性中有9%有无症状胆结石。在40岁及以上年龄组中，男性（14%）和女性（11%）的患病率差异无统计学意义。在女性中，既往妊娠次数是一个显著的危险因素（卡方 = 5.4，P = 0.02）。例如，既往妊娠0次、3次和6次及以上的女性中胆结石的总体发生率分别为3%、8%和17%。在对年龄、体重指数进行校正后，对于女性还对妊娠次数进行校正的逐步逻辑回归分析发现，与种族（P = 0.40）、高血压（P = 0.43）、心脏病（P = 0.47）或糖尿病（P = 0.46）无关，不存在显著增加的风险。年龄校正后，不存在显著的性别效应（P = 0.25）。无症状胆结石在40岁以上男性和30岁以上女性中相对常见。虽然年龄是男性唯一的显著危险因素，但肥胖、产次以及在较小程度上年龄是女性的显著危险因素。
