Apstein M D, Dalecki-Chipperfield K
Gastroenterology. 1987 Apr;92(4):966-8. doi: 10.1016/0016-5085(87)90971-1.
The purpose of this study was to determine the prevalence of gallstone disease among patients with a spinal cord injury. We identified all patients with a spinal cord injury of greater than 2 weeks' duration who died and underwent an autopsy between 1975 and 1985. These 38 patients with spinal cord injury were age-, sex-, and race-matched with 38 patients without spinal cord injury who underwent an autopsy during the same period. Gallstone disease was significantly more prevalent in patients with spinal cord injury (11 of 38 or 29%) compared to the control population (4 of 38 or 11%) (p less than 0.05; odds ratio of 3.46 with 95% confidence interval of 1.08-11.24). A significant difference in age or level or duration of spinal cord injury was not found between patients with spinal cord injury who had gallstone disease and those who did not. Possible explanations for this threefold increase in risk of gallstone disease among patients with spinal cord injury include abnormal gallbladder motility resulting in stasis, decreased intestinal transit leading to an abnormal enterohepatic circulation, and metabolic changes leading to abnormal biliary lipid secretion.
本研究的目的是确定脊髓损伤患者中胆结石疾病的患病率。我们识别出了所有在1975年至1985年间死亡并接受尸检、脊髓损伤持续时间超过2周的患者。这38例脊髓损伤患者在年龄、性别和种族方面与同期接受尸检的38例无脊髓损伤患者相匹配。与对照组人群（38例中的4例，即11%）相比，脊髓损伤患者中胆结石疾病的患病率显著更高（38例中的11例，即29%）（p<0.05；优势比为3.46，95%置信区间为1.08 - 11.24）。在患有胆结石疾病的脊髓损伤患者与未患胆结石疾病的脊髓损伤患者之间，未发现年龄、脊髓损伤水平或持续时间存在显著差异。脊髓损伤患者胆结石疾病风险增加三倍的可能解释包括胆囊运动异常导致胆汁淤积、肠道运输减少导致肝肠循环异常以及代谢变化导致胆汁脂质分泌异常。
