Cirrhosis And The Preliminary Study Of The Relationship Between The Gallbladder And Vip And Cck

Aim To investigate gallbladder's changes in liver cirrhosis and its related affecting factors. Method :(1) Clinical materials of 682 cirrhotics were retro-analyzed and stratified by Child-Pugh into 3 groups,each group's gallbladder wall thickness ,the occurence of cholecystitis and gallstone and levels of serum TBA and ALB were compared. (2) The gallbladder's pre- and postprandial volumes in 30 cirrhotics,10 hepatitis B and 26 controls are checked by B-ultrasonic, and their postprandial gallbladder emptying rates (PGER)were calculated respectively and the plasma levels of CCK and VIP were measured. Result: (1) Among 682 cirrhotics, 492(72.1%)patients had a thicker gallbladder wall,and 143(20.9%)patients had gallstone, and 98(14.3%)patients had cholecystitis. Of all cholecystitis, the occurence rate was highest in Child C groups, but no difference between ChildA and ChildB groups;(2) PGER in controls,hepatitis B,patients with Child A,Child B and Child C were(75.4±2.8)%,(61.3±5.6),(63.2±1.7)%,(55.3±2.2)% and(41.2±1.2)% respectively,Controls group > Child A(or hepatitis group) > Child B >Child C(P<0.05)compared by PGER ; The preprandial plasm CCK(pg/ml) in hepatitis group ,Child A,Child B and Child C groups were 187.7±30.6; 194.6±27.2; 233.1±35.5; 274.8±41.1 respectively; and VIP(pg/ml) were 58.3±5.2; 61.5±8.2; 94.3±13.7; 141.5±27.6 respectively; The postprandial CCK(pg/ml) were 211.8±29.7; 256.7±42.8; 272.6±34.4; 305.7±43.7 respectively ; and VIP(pg/ml) was 69.6±6.8; 72.1±7.7; 110.5±15.3; 157.2±28.1 respectively . There were significant difference(P<0.05)between each group except ChildA and hepatitis B. Conclusion:(1) The more advanced cirrhotics, the thicker the gallbladder wall ,the higher the occurence rate of gallstone,and moreover, they were related positively to the serum TBA, negatively to the serum ALB; (2) The PGER in cirrhotics was markedly lower than those of controls, the more advanced cirrhotics,the lower the PGER was, which may be related to the receptor changes of CCK and VIP.