Analysis Of Risk Factors Of Gallstones In Patients With Cirrhosis Of The Liver

Objective Cirrhosis of the liver is to point to by one or more of the cause(hepatitis,chronic alcoholism,drugs,poisons,autoimmune,cholestasis,etc.)caused by disease,developing in liver cirrhosis,liver cells are scattered in the widespread damage,liver cells reduce and increased collagen synthesis and degradation,remnant liver cell regeneration,at the same time remaining liver lobules were rebuilt is false,false flocculus characteristic of cirrhosis of the liver pathology.Gallstone is a common disease in China,in recent years,the incidence of gallstone has increased.Studies have shown that the incidence of gallstones in patients with cirrhosis is higher than that in normal people,and the severity of cirrhosis significantly increases the risk of stone formation.After cirrhosis patients with gallbladder stones,their clinical symptoms may not be obvious,may be covered by the symptoms of cirrhosis itself,leading to missed diagnosis,misdiagnosis,delay the patient’s condition;The main treatment for surgical treatment of gallstone disease,but may merge blood coagulation dysfunction in patients with cirrhosis,hypoalbuminemia,etc.,and low resistance in patients with cirrhosis,the above various factors lead to increasing of the surgery itself is difficult and postoperative complications,and the existing related research suggests that cirrhotic patients with symptomatic gallbladder stone of mortality is higher.Therefore,it is necessary to explore the related factors of cirrhosis complicated with cholecystolithiasis,so as to provide theoretical basis for clinical diagnosis and treatment of cirrhosis patients and early intervention.Methods A retrospective analysis was performed on 128 patients with cirrhosis admitted to department of Gastroenterology,Hefei First People’s Hospital from July,2017 to July,2019,Patients with cirrhosis combined with gallstones were set as the observation group(a total of 45 cases),while those without gallstones were set as the control group(83 cases).All the enrolled patients were clearly diagnosed with cirrhosis by clinical history,laboratory and imaging examination.Patients with age≤18 years old,previous history of gallbladder or liver surgery,patients with hematologic diseases,patients with severe cardiac and renal insufficiency,patients with malignant tumors,and patients with incomplete data were excluded.At the same time,a total of 211 people underwent abdominal ultrasound examination in the physical examination center of Hefei First People’s Hospital during the same period as the normal control group were collected.To compare the incidence of gallstones between cirrhosis and normal population,By single factor analysis and comparison between observation group and control group in gender,age,liver function Child-pugh,grading,albumin levels(propagated),total bilirubin(TBIL),direct bilirubin(DBIL)and indirect bilirubin(IBIL),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),low density lipoprotein(VLDL),GGTP(gamma glutamyl transpeptidase)(GGT),alkaline phosphatase(ALP)indicators such differences.The risk factors of gallstones in patients with cirrhosis were determined by binary Logistic analysis.At the same time,we also analyzed whether there was any difference in the incidence of gallstone in cirrhosis caused by different etiologies.Results 1.In this study,there were 128 patients with cirrhosis,including 45 patients with gallstones,with an incidence of 35.15%;There were 211 cases of normal physical examination,and 14 cases were complicated with gallstones,with an incidence of 6.63%.The difference in the incidence of gallstones between the two groups was statistically significant(c2=45.083,P=0.000<0.05);2.In the univariate analysis,there were statistically significant differences in age,albumin level(ALB),child-pugh grading of liver function,alkaline phosphatase(ALP),and low-density lipoprotein cholesterol(LDL-C)(P<0.05);Binary Logistic analysis showed that age(OR=1.037,P=0.017),albumin level(OR=0.908,P=0.016),child-pugh grade of liver function(OR=2.209,P=0.012),LDL-C(OR=0.621,P=0.046),suggesting that advanced age,high child-pugh grade of liver function,low albumin level,and low LDL-C were risk factors for patients with liver cirrhosis complicated with gallstones.3.Specifically,in terms of child-pugh classification of liver function,liver cirrhosis patients were divided into three groups according to child-pugh classification of liver function.There were 75 patients in group B with liver function grade,and 27 patients were complicated with gallstone.There were 22 patients in the liver function grade C group,including 12 patients with gallstones,and the difference was statistically significant(P=0.008<0.05).4.The incidence of gallstones in patients with hepatitis C cirrhosis was the highest(50%),higher than that in patients with hepatitis B cirrhosis(c2=4.143,P=0.042<0.05)and Patients with alcoholic cirrhosis(c2=4.327,P=0.038<0.05).Conclusion The incidence of gallstones in patients with cirrhosis is higher than that in the normal population;Patients with HEPATITIS C cirrhosis are more likely to have gallstones than those with hepatitis B cirrhosis or alcoholic cirrhosis;For patients with cirrhosis,their old age,high child-pugh grade of liver function,low albumin level and low LDL-C are risk factors for cirrhosis complicated with gallstone.Therefore,for patients with cirrhosis,we should actively correct hypoproteinemia,actively control the progression of liver disease,improve liver function,and improve dyslipidemia.