Karaciger sirozundaki artmis kolelitiyazis sikliginda hepatit B’nin rolu: Vaka kontrollu sonografik bir çalisma
The role of hepatitis B on increased cholelithiasis frequency in liver cirrhosis: A case controlled sonographic survey
- Ana Sayfa
- Sayılar
- Karaciger sirozundaki artmis kolelitiyazis sikliginda hepatit B’nin rolu: Vaka kontrollu sonografik bir çalisma...
Özet
Giris ve amaç: Karaciger sirozunun kolelitiyazis ile iliskisi pek çok çali smaya konu olmustur. Sirozda kolelitiyazis prevalansini ve bölgemizdeki en sik siroz nedeni olan HBV hepatiti ile olan iliskisini, vaka kontrollu sonografik bir çalismayla arastirmayi amaçladik. Gereç ve yöntem: Eylül 2001 ile Haziran 2003 tarihleri arasinda Dicle Üniversitesi Hastanesine yatmis toplam 85 karaciger sirozlu olgu çalismaya alindi. Bunlarin 61’i erkek ve 24’ü kadin olup, yas ortalamalari 45.7 idi. Ayri ca poliklinige baska nedenlerle basvurmus 86 saglikli hasta yakini (55’i erkek ve 31’i kadin olup yas ortalamalari 46.8) kontrol gurubu olarak seçildi. Karaciger sirozunun etyolojisi 68 hastada HBV hepatiti, 7 HCV hepatiti, l alkol, 3 otoimmün hepatit, 2 Wilson hastaligi ve 1 hastada hemokromatozis idi. Hastalarin 9’u Child A, 26’si Child B ve 50’si Child C kategorisindeydi. Hastalarin yaslari < 40 (n=18), 40-60 (n=45), >60 (n=22) seklinde üç guruba ayrildi. Çalismaya alinan bireylerin tümüne hepatobiliyer ultrasonografi yapildi. Istatistiksel veri analizleri chi-square testi (gereginde de Fisher-exact test) kullanilarak gerçeklestirildi. Bulgular: Kontrol gurubundaki %6.9’luk orana karsilik sirotik hastalardaki kolelitiyazis toplam prevalansi %17.6 idi (p=0.034 X2=4.51 OR=2.86, %95 CI =1.05-7.76). Yas arttikça artan kolelitiyazis sikligi vardi (p<0.05). Kolelitiyazis ile cinsiyet, sirozun siddeti ve HBsAg-negatif / HBsAg-pozitifligi arasinda anlamli bir iliski saptanmadi (p>0.05). Sonuç: Sirozlu hastalarda kontrol gurubuna oranla 2.86 kat artmis kolelitiyazis sikligi bulduk. Bölgemizde HBV’ye bagli sirozda görülen kolelitiyazis sikligi diger sirotiklerden farkli degildi.
Abstract
Background and aims: The relationship between liver cirrhosis and cholelithiasis has been the subject of many studies. Our objective was to assess the prevalence of cholelithiasis in cirrhosis and its relationship with the most common etiological factor of cirrhosis in our region, HBV hepatitis, by means of a case controlled sonographic survey. Material and methods: Eighty-five patients with liver cirrhosis who were hospitalized at Dicle University Hospital between September 2001 and June 2003 were included in the study. Sixty-five were male and 24 female, with an average age of 45.7 years. In addition, 86 relatives (55 male, 31 female with 46.8 average age) of outpatients who admitted to the polyclinics were selected as the control group. The etiological classification of liver cirrhosis was: 68 HBV hepatitis, 7 HCV hepatitis, 4 alcohol abuse, 3 autoimmune hepatitis, 2 Wilson’s disease and 1 hemochromatosis. Nine were in Child A, 26 in Child B and 50 in Child C category. Classes for age were in three groups: < 40, 40-60, >60. Hepatobiliary ultrasonography was performed on all subjects included in the study. Statistical analysis of data was performed using chi-square (Fisher’s exact test as needed). Results: The overall prevalence of cholelithiasis in cirrhotic patients was 17.6% versus 6.9% in the control group (p=0.034, X2=4.51, OR=2.86, 95% CI =1.05-7.76). The prevalence showed an increasing rate with age (p<0.05). There was no significant relationship between cholelithiasis and gender, severity of cirrhosis and HBsAg-negative/ HBsAg-positive groups (p>0.05). Conclusions: Cirrhosis caused increase in the risk of cholelithiasis 2.86 times more than in the control group. There was no significant difference in the cholelithiasis rate in HBV hepatitis and in other etiological factors for cirrhosis in our region.
