肝硬化患者合并胆囊壁增厚的临床分析

目的探讨肝硬化患者合并胆囊壁增厚的发生率及其机制。方法回顾性分析118例肝硬化组与165例住院健康体检对照组的B超及肝功能资料．比较肝硬化胆囊壁增厚发生率与性别、门静脉内径宽度、血清白蛋白浓度、凝血酶原时间、腹水及Child—pugh分级的关系。结果肝硬化组胆囊壁增厚者达80．51％，明显高于对照组，差异有统计学意义（x^2=180．74，P〈0．05）。与肝硬化胆囊壁正常组比较，肝硬化胆囊壁增厚组门静脉宽度增加、血清白蛋白浓度降低、凝血酶原时间延后、腹水发生率增加，差异均有统计学意义（t分别=2．26、9．18、4．43，x^2=-18．32，P均〈0．05）。与肝功能Child—pugh A组比较，Child—pugh B、Child—pugh C患者胆囊壁增厚发生率明显增加，差异有统计学意义（x^2=7．66、19．49，P均〈0．05）。结论肝硬化患者往往伴有胆囊壁增厚。肝硬化患者胆囊壁增厚的原因是多因素的。胆囊壁增厚对判断肝实质病变的严重程度有一定的参考价值。

Clinical analysis of gallbladder wall thickening in patients with liver cirrhosis

Objective To investigate the incidence and mechanism of gallbladder wall thickening in patients with liver cirrhosis. Methods Data of sonography B and liver function of 165 healthy persons and 118 patients with liver cirrhosis were analyzed. The relationship of thickening incidence with gender, width of portal vein, ALB concentration in serum, prothrombin time, ascites and Child-Pugh classification were analyzed. Results Of all the patients with liver cirrhosis 80.51% had gallbladder wall thickening,which was significantly higher than normal control group （x^2=lS0.74,P〈0.05）. There were significant differences in width of portal vein, ALB concentration in serum, prothrombin time and the incidence rate of ascites in gallbladder wall thickening patients compared with non-thickening patients in cirrhotic group （t=2.26,9.18,4.43; x^2=18.32, P〈0.05）. The incidence of gallbladder wall thickening in Child-Pugh B and C grade was higher than Child-Pugh A grade （x^2=7.66, 19.49, P〈0.05）. Conclusions Patients with liver cirrhosis also have gallbladder wall thickening . There are many reasons for gallbladder wall thickness in liver cirrhosis patients. Gallbladder wall thickening has reference value to judge the degree of liver parenchyma disease.