Sulaberidze G T, Rachvelishvili N B, Zhamutashvili M T, Barbakadze G G
Georgian Med News. 2009 Mar(168):56-60.
The aim of this study was to identify the influence of HBV on gall bladder and to establish necessity and terms of preventive measures. For this reason we have examined 58 patients, passed through cholecystectomy and 142 patients with B hepatitis. Patients of this group were followed up during 18 months. In the first group presence HBsAg in the gall bladder tissue was identified using immunoferment analysis and immunofluorescent testing. In all cases the blood was tested for specific markers (HBsAg, Anti-HB-cor antibodies of G and M classes). In the second group 75 patients were investigated prospectively. Observation using ultrasound was performed to find out the changes of gall bladder and bile. In this group preventive measures against gallstone formation were performed. 67 patients were investigated retrospectively and prevention was not performed among them. In 10 cases of cholecystectomy (17,2%) out of 58, HBsAg in the gall bladder tissue was identified both, with immunoferment analysis and immunofluorescent testing. The ultrasound examination revealed morpho-functional changes of gall bladder and bile in the acute stage of hepatitis B and also in following period. There were no cases of development of gallstones in the group where preventive measures using dietary fiber-rich food "Margi" were conducted, in the second group, where such measures have not been performed, gallstones developed in 5 patients (7,46%) out of 67, during 6-18 months after the acute B hepatitis. This results allow us to conclude, that cholecystopathogenic influence of HBV leads to the morpho-functional changes of gall bladder. This fact must be assessed as a risk factor for development of cholelithiasis and confirms necessity of early longlasting preventive measures.
本研究的目的是确定乙肝病毒（HBV）对胆囊的影响，并确定预防措施的必要性和条件。为此，我们检查了58例接受胆囊切除术的患者和142例乙型肝炎患者。对该组患者进行了18个月的随访。在第一组中，使用免疫酶分析和免疫荧光检测在胆囊组织中鉴定出HBsAg。在所有病例中，均检测血液中的特异性标志物（HBsAg、G和M类抗HB-cor抗体）。在第二组中，对75例患者进行了前瞻性研究。采用超声观察以发现胆囊和胆汁的变化。在该组中采取了预防胆结石形成的措施。对67例患者进行了回顾性研究，其中未采取预防措施。在58例胆囊切除术中，有10例（17.2%）通过免疫酶分析和免疫荧光检测在胆囊组织中均鉴定出HBsAg。超声检查显示，在乙型肝炎急性期及随后时期，胆囊和胆汁出现形态功能改变。在采取富含膳食纤维食物“Margi”进行预防措施的组中，未出现胆结石病例；在第二组中，未采取此类措施，67例中有5例（7.46%）在急性乙型肝炎后6至18个月出现胆结石。这些结果使我们得出结论，HBV的胆囊致病影响导致胆囊形态功能改变。这一事实必须被视为胆结石形成的危险因素，并证实了早期长期预防措施的必要性。
