| According to epidemiological studies, gallstone disease is a very common and frequently-occurring disease of surgery in clinical practice, which may occur in gallbladder, extra and intrahepatic duct. However, the major risk factors for cholelithiasis in China have not been completely identified. Recently, the number of patients suffering from Cholesterol gallstone disease raises remarkably, even results in two times increasing each ten years. Our research was designed to investigate the associated factors of gallstone, so as to providing evidence for its prevention.In view of incorrespondency in the present conclusions regarding risk factors, we designed a 1:1 pair matched case-control study. All of the cases have been diagnosed with ultrasound and operation. Conditional logistic regression was used to analyze which factors were associated with the incident cases of gallstones, in order to proffer valuable, credible reference and experience.Clinical and epidemiological data were collected by means of a questionnaire. A total of 200 subjects were included in this study: 100 with gallstone (underwent an upper abdominal ultrasound examination at which the presence of gallbladder stones was surgically ascertained) inpatients who were admitted to hepatobiliary surgical department in Tianjin 3rd central hospital affiliated to Tianjin Medical University from August 2001 to March 2002, and 100 controls without gallstone disease. All subjects reside in Tianjin for more than 6 years and are able to offerclinical and epidemiological information or complete questionnaire relating to food and alcohol consumption, smoking, gastrointestinal symptoms. The patients in control group were matched with cases in the same sex, the same age group, and in the same period in our hospital and were screened for the absence of gallstones by gallbladder ultrasonography.According to the requisition of model, we perform the variant standardization and quantity, and statistical processing of the data using conditional logistical regression techniques in SAS software. Then the application of professional knowledge to used to adjust the confounding of results of univariate analysis and multivariate analysis. At last, certain miscellaneous factors were readjusted to control confoundings interferrance between them and progressively introduced significant variables to fit a main effects pattern.The results reveal that cholecystitis is a risk factor of gallstones disease, OR is 44.000 (95%CI 6.062-319.354), and its hazard effect enhance if incorporate drinking alcohol, edible food habits fried-hoppy. Also a diet rich in carbohydrates, OR is 1.717 ( 95%CI 1.177-2.504 ), and a diet rich in animal oil with OR=2.541 ( 95%CI 1.280-5.045 ) are risk factors. One grade kinsfolk especially sibling with OR^6.500 (95%CI 1.467-28.804 ) with gallstones disease and more labors with OR=3.667 ( 95%CI 1.023-13.143 ) in female are the other risk factors. In addition, social psychological factors have intimate relationship with especially, outer irritant character by the adjustment of character. A tea and vegetable consumption have a certain degree of sheltering fromcholelithiasis, whereas long period resident of Tianjin and the decreased first labor age or oral taking of contercenceptive drugs seem to be protection factors. Multivariate analysis confirmed these results. And other items including smoking drinking alcohol, BML exercise x career or taking other drugs show no significant relations to gallstones. As a result, cholecystitis ( X26) and taking animal oil ( X6g): acts as two major risk factor in both men and women of the terminal matrix lnOR=3.7983*X26+0.9660*X68Our study suggests that cholecystitis, large amount intake of carbohydrates and consumption of animal fat, family history of gallstones (esp. sibling positive) and more labors in female positively be correlated with gallstones. Besides, social psychological factors have intimate relationship with gallstones and were identified as significant risk factors based on a rudimental b... |
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