■胆囊和胆结石的形态变化在肝硬化患者中很常见,但它们与肝硬化患者结局的关联尚不清楚.
■我们回顾性地纳入了206例肝硬化患者,并测量了他们的胆囊长度和宽度,胆囊壁厚,胆结石的存在,和胆结石的长度和宽度在轴向对比增强计算机断层扫描(CT)图像。X-tile软件用于计算这些参数的最佳临界值,以评估肝硬化组中的生存和肝功能失代偿事件。通过Cox回归分析和Kaplan-Meier曲线分析探讨其与生存的关系。通过竞争性风险分析和Nelson-Aalen累积风险曲线分析评估其与肝失代偿事件的关联,其中死亡是竞争性事件。
■胆囊长度<72mm的肝硬化患者的累积生存率明显高于长度≥72mm的患者(通过对数秩检验,P=0.049),但是胆囊的宽度,胆囊壁厚,胆结石的存在,和胆结石的长度和宽度与生存率没有显着相关(通过对数秩检验,P=0.10,P=0.14,P=0.97,P=0.73和P=0.73,分别)。胆囊壁厚度<3.4mm的肝硬化患者的肝失代偿事件累积率明显低于壁厚度≥3.4mm的患者(Gray检验P=0.02),但是胆囊的长度和宽度,胆结石的存在,胆结石的长度和宽度与肝脏失代偿事件无显著相关(P=0.15,P=0.15,P=0.54,P=0.76,P=0.54,分别)。
■胆囊长度和胆囊壁厚的变化,而不是胆结石参数,可能与肝硬化患者的长期结局平行。
UNASSIGNED: Morphologic changes in the gallbladder and gallstones are common in cirrhotic patients, but their associations with outcomes of cirrhotic patients are unclear.
UNASSIGNED: We retrospectively enrolled 206 cirrhotic patients and measured their gallbladder length and width, gallbladder wall thickness, presence of gallstones, and gallstones\' length and width in axial contrast-enhanced computed tomography (CT) images. X-tile software was utilized to calculate the optimal cutoff values of these parameters for evaluating survival and hepatic
decompensation events in the cirrhosis group. Their associations with survival were explored by Cox regression analyses and Kaplan-Meier curve analyses. Their associations with hepatic
decompensation events were evaluated by competing risk analyses and Nelson-Aalen cumulative risk curve analyses where death was a competing event.
UNASSIGNED: Cirrhotic patients with gallbladder length < 72 mm had a significantly higher cumulative survival rate than those with a length of ≥ 72 mm (P = 0.049 by log-rank test), but gallbladder width, gallbladder wall thickness, presence of gallstones, and gallstones\' length and width were not significantly associated with survival (P = 0.10, P = 0.14, P = 0.97, P = 0.73, and P = 0.73 by log-rank tests, respectively). Cirrhotic patients with gallbladder wall thickness < 3.4 mm had a significantly lower cumulative rate of hepatic
decompensation events than those with a wall thickness of ≥ 3.4 mm (P = 0.02 by Gray\'s test), but gallbladder length and width, presence of gallstones, and gallstones\' length and width were not significantly associated with hepatic
decompensation events (P = 0.15, P = 0.15, P = 0.54, P = 0.76, and P = 0.54 by Gray\'s tests, respectively).
UNASSIGNED: Changes in gallbladder length and gallbladder wall thickness, rather than gallstone parameters, may be in parallel with the long-term outcomes of cirrhotic patients.