探讨无症状胆囊结石患者随访期间出现临床症状的影响因素，为无症状胆囊结石患者随访和治疗提供选择依据。

回顾性分析2019年1月至2020年12月1 684例无症状胆囊结石患者临床资料，根据随访期间是否出现临床症状分为进展组（n=173）和无进展组（n=1 511），数据采用SPSS 23.0软件进行统计学分析，单因素和多因素分析采用Logistics回归模型。以P<0.05为差异有统计学意义。

1 684例患者随访期间内173例出现临床症状，发生率为10.3%。单因素分析发现进展组中女性、糖尿病、熬夜、饮食不规律、结石≤5 mm、结石多发、高脂血症患者比例高于无进展组（P<0.05），多因素分析发现糖尿病、饮食不规律、结石≤5 mm、多发结石是无症状性胆囊结石出现临床表现的危险因素（P<0.05）。进展组中，74例（42.8%）胆囊结石数量增多、31例（17.9%）结石直径增大、19例（11.0%）结石数量增多且结石增大、49例（28.3%）结石数量和大小无变化；106例（61.3%）表现为胆囊炎、42例（24.2%）表现为胆管炎、25例（14.4%）表现为胆源性胰腺炎；接受手术治疗患者155例（89.6%）、拒绝手术治疗患者18例（10.4%）。

糖尿病、饮食不规律、结石≤5 mm、多发结石是无症状性胆囊结石患者病情进展的危险因素，对于这类患者可以考虑早期手术治疗，避免出现严重临床表现，耽误治疗。

To explore the influencing factors of clinical symptoms in patients with asymptomatic cholecystolithiasis during the follow-up period，and to provide a basis for the follow-up and treatment of patients with asymptomatic cholecystolithiasis.

Clinical data of 1684 patients with asymptomatic cholecystolithiasis from January 2019 to December 2020 were retrospectively analyzed，and divided into progressive group（n=173）and non-progressive group（n=1 511）according to whether clinical symptoms occurred during the follow-up period. Data were statistically analyzed using SPSS 23.0 software. Logistics regression model was used for univariate and multivariate analysis. P<0.05 was considered to be statistically significant.

During the follow-up period，173 of 1 684 patients showed clinical symptoms，with an incidence of 10.3%. Univariate analysis found that the proportion of women，diabetes，staying up late，irregular diet，stones ≤5 mm，multiple stones，and hyperlipidemia in the progressive group was higher than that in the non-progressive group（P<0.05），and multivariate analysis found diabetes，irregular diet，stones ≤5 mm and multiple calculi were risk factors for clinical manifestations of asymptomatic gallstones（P<0.05）. In the progressive group，74 patients（42.8%）had increased gallstone number，31 patients（17.9%）had increased stone diameter，19 patients（11.0%）had increased stone number and increased stone size，and 49 patients（28.3%）had no change in stone number and size. 106 cases（61.3%）showed cholecystitis，42 cases（24.2%）cholangitis and 25 cases（14.4%）biliary pancreatitis. 155 patients（89.6%）received surgery and 18 patients（10.4%）refused surgery.

Diabetes，irregular diet，stones ≤5 mm，and multiple stones are risk factors for the progression of asymptomatic cholecystolithiasis. For these patients，early surgical treatment can be considered to avoid serious clinical manifestations and delay of treatment.