非胆源性疾病胆囊壁双边影与低蛋白血症的关系

目的分析肝硬化和肾病综合征（NS）患者胆囊壁的声像图特点，探讨胆囊壁双边影的形成与低蛋白血症的关系。方法肝硬化患者75例和NS患者43例，检测其血清白蛋白浓度，肝硬化患者按血清白蛋白浓度分为〉35g／L、30～35g/L、〈30g／L3组，超声测量胆囊壁厚度。结果肝硬化组胆囊壁增厚的发生率高于NS组（P〈0．01），肝硬化组胆囊壁增厚患者中胆囊双边影的发生率低于NS组，但二者差异无统计学意义（P〉0．05）。NS组白蛋白浓度低于肝硬化组（P〈0．05），胆囊壁增厚患者随着白蛋白浓度降低（P〈0．01），胆囊壁双边影的发生率逐渐增加，但各组发生率无统计学差异（P〉0．05），白蛋白〉35g／L组双边型胆囊壁的厚度小于其他组（P〈0．05）。结论低蛋白血症可能是非胆源性疾病胆囊壁双边影形成的一个主要机制，白蛋白水平越低，胆囊壁双边影的发生率越高，通过超声观察胆囊壁的变化可间接反应其水平。

The relationship between double-walled gallbladders and hypoproteinemia in non-gallbladder disease

Objective To analyze the sonogram features of gallbladder wall in patients with liver cirrhosis and nephritic syndrome （NS）, and to investigate the relationship between double -walled gallbladders and hypoproteinemia. Methods Seventy - five patients with liver cirrhosis and 43 patients with NS were enrolled in this study, their serum albumin level was measured. According to the serum albumin level, patients with liver cirrhosis were divided into 3 groups, serum albumin level more than 35g/L group, between 30g/L and 35g/L group and less than 30g/L group,respectively. Then the thickness of gallbladder wall was measured by ultrasound. Results The incidence of gallbladders wall thickening in liver corrhosis group was higher than that in NS group（ P 〈 0.01 ）, while the incidence of double -walled gallbladders in eorrhosis group was lower than that in NS group, there was no difference between two groups （ P 〉 0.05 ）. The serum albumin level in NS group was lower than that in liver cirrhosis group （P 〈 0.05 ）. The incidence of double - walled gallbladders in liver cirrhosis group and NS group was increased with serum albumin level decreased, while there was no significant difference between each groups （P 〉 0.05 ）. The thickness of double - walled gallbladders in serum albumin level more than 35g/L group was less than that in other groups （ P 〈 0.05 ）. Conclusion Hypoproteinemiaeould be a primary mechanism to cause double - walled gallbladders in non - gallbladder disease. With the decrease of serum albumin level, the incidence of double - walled gallbladders is increased, and ultrasound can indirectly reflect the changes of double - walled gallbladders.