The Study On The Relationship Between Hepatitis C Virus Related Chronic Liver Disease And Gallstone

Objective:Based on 1686 cases of hepatitis C virus related chronic liver disease,gallstone incidence,clinical characteristics and risk factors were analyzed retrospectively,to investigate the relationship between different types of hepatitis C virus related chronic liver disease and gallbladder stones,provide clinical and theoretical basis for the prevention and treatment of such patients with gallbladder stones.Methods:During the extraction of our hospital from January 1,2008 to June 30,2016,1686 patients who were diagnosed as hepatitis C virus related chronic liver disease in hospitalized in the Department of hepatobiliary are choosed,including 904 patients with chronic hepatitis and 582 cases of liver cirrhosis after hepatitis C,hepatitis C cirrhosis associated with hepatocellular carcinoma in 157 cases.In the same period,1716 patients with non-liver disease were selected as control group.All patients underwent abdominal ultrasonography.Firstly,to compare the difference of the incidence of gallstones in patients with chronic hepatitis C and non-liver disease.Secondly,each group were divided into 2 groups according to whether the gallbladder stones,and statistical analysis of the differences such as age,gender,Child-Pugh score,aspartate aminotransferase,alanine aminotransferase,r-glutamyl transpeptidase,alkaline phosphatase,albumin,cholinesterase,total bilirubin,blood coagulation the function index between the two groups were included.Any more,we also explore the influence of hypertension,diabetes,cholecystitis,fatty liver disease etal.for the incidence of gallstones in each group.Result:1.Incidence of gallbladder stones in chronic hepatitis C,hepatitis C cirrhosis,hepatitis C cirrhosis complicated with hepatocellular carcinoma were 14.71%,30.5%,34.39%,higher than the non-liver disease(9.67%)(p<0.001).Among them,hepatitis C cirrhosis,hepatitis C cirrhosis with hepatocellular carcinoma complicated by cholecystolithiasis were higher than that of chronic hepatitis C(p<0.001),However,no significant differences between the two before(p=0.361).2.The single factor of chronic hepatitis C patients with gallbladder stones showed that average age,aspartate aminotransferase,alanine aminotransferase,rglutamyl transpeptidase,alkaline phosphatase,total bilirubin level were higher in the chronic hepatitis C with gallstone group than that of non gallstone group(p <0.05),but the average level of cholinesterase was lower than that of non stone group(p<0.05).Secondly,the incidence of hypertension,cholecystitis was also higher than that of no stone group(p<0.05).Logistic regression analysis indicate that age(p<0.001,OR=1.044,95%CI 1.025-1.064),AST(p=0.039,OR=1.002,95%CI 1.000-1.004),Cholecystitis(p<0.001,OR=2.724,95%CI1.773-4.185)are independent risk factors for chronic hepatitis C patients with gallstones.3.Comparison of the incidence of gallbladder stones in 3 different grades of liver function after hepatitis C virus infectiion: the incidence of gallstoes in B grade(33.5%)and C grade(36.36%)was higher than that of Grade A(25%)(p=0.041,p=0.036),but the incidence of gallstones in the two before had no significant difference(p=0.607).4.The univariate analysis of Hepatitis C cirrhosis with gallbladder stones showed that average age,level of TBIL and combined with cholecystitis and ascites incidence was higher in the hepatitis C cirrhosis associated with gallstone patients than that of patients without gallstone group(p<0.05).Logistic regression analysis showed that age(p=0.018,OR=1.024,95%CI,1.004-1.044)? ascites(p=0.009,OR=1.661,95%CI 1.134-2.433),cholecystitis(p<0.001,OR=3.527,95%CI,2.372-5.107)were independent risk factors of hepatitis C cirrhosis complicated with gallstones.5.Analysis of risk factors for hepatitis C cirrhosis with hepatic cell carcinomaassociated with gallstone: univariate analysis showed that the average age,ALT,GGT,TBIL level,and the incidence of cholecystitis in the patients of hepatitis C cirrhosis associated with hepatocellular carcinoma combined with cholecystolithiasis was higher than that of no cholecystolithiasis patients(p<0.05).Logistic regression analysis showed that age(p=0.003,OR=1.072,95%CI 1.024-1.122)?ALT(p=0.026,OR=1.010,95%CI 1.001-1.019)?cholecystitis(p<0.001,OR=6.251,95%CI 2.853-13.695)are Independent risk factors for hepatitis C cirrhosis associated with HCC and GS.6.Analysis of risk factors of non-liver disease patients with gallstone :cholecystitis(p<0.001,OR=15.489,95%CI,9.828-24.4),fatty liver disease(p=0.013,OR=1.596,95%CI,1.105-2.305),age(p<0.001,OR=1.034,95%CI,1.021-1.047)are independent risk factors in patients with liver and gallbladder stones.Conclusion:1.In patients with hepatitis C virus related chronic liver disease,the incidence of gallstone is significantly higher than that of non liver disease,and the more serious liver disease,the higher the incidence of gallstones,but no significant difference in gender.2.In the hepatitis C virus related Chronic liver disease,elderly and the presence of cholecystitis are conmon independent risk factors for gallbladder stones,and ascites is an independent risk factor for gallstone formation with hepatitis C cirrhosis.however,the presence of fatty liver disease leads to a higher risk of gallstones in patients with non liver disease.