Fornari F, Imberti D, Squillante M M, Squassante L, Civardi G, Buscarini E, Cavanna L, Caturelli E, Buscarini L
First Department of Medicine, Hospital of Piacenza, Italy.
J Hepatol. 1994 Jun;20(6):797-801. doi: 10.1016/s0168-8278(05)80152-7.
One hundred and sixty-five patients with cirrhosis were prospectively investigated, by regular ultrasonographic follow up, to assess the incidence of gallstones. The mean length of follow up was 33 months (range 12 to 108). Cholelithiasis was diagnosed in 31 patients (18.8%), with a cumulative incidence over 84 months of 38.3% (4.7% yearly incidence). The risk of gallstones was similar in males (38%) and females (38.3%), although the final cumulative incidence was reached at 72 months in males. The percentage of patients with new stones was higher in alcoholic cirrhosis (28.9%) (with a cumulative incidence of 48.8% at 84 months) and lower in hepatitis-related cirrhosis (1.9%) (only one new case at 96 months of follow up) (p < 0.001). The cumulative incidence of gallstones in the Child's C group reached 49.3% at 48 months versus 24% in Child's B and 6.4% in Child's A (p < 0.0001). At multivariate analysis, Child's C and alcoholic cirrhosis were shown to be the independent variables significantly associated with a high risk of development of cholelithiasis. This study confirms that cirrhosis represents a high risk factor for gallstones. The risk is greater for alcoholic cirrhosis and increases with the severity of the disease.
对165例肝硬化患者进行了前瞻性研究，通过定期超声随访来评估胆结石的发生率。平均随访时间为33个月（范围12至108个月）。31例患者（18.8%）被诊断为胆石症，84个月的累积发病率为38.3%（年发病率为4.7%）。男性（38%）和女性（38.3%）患胆结石的风险相似，尽管男性在72个月时达到最终累积发病率。酒精性肝硬化患者中新发结石患者的比例更高（28.9%）（84个月时累积发病率为48.8%），而肝炎相关性肝硬化患者中这一比例较低（1.9%）（随访96个月时仅1例新病例）（p<0.001）。Child's C组胆结石的累积发病率在48个月时达到49.3%，而Child's B组为24%，Child's A组为6.4%（p<0.0001）。多变量分析显示，Child's C级和酒精性肝硬化是与胆结石发生高风险显著相关的独立变量。本研究证实，肝硬化是胆结石的一个高风险因素。酒精性肝硬化的风险更大，且随着疾病严重程度增加。
