摘要
目的新生儿肝内胆汁淤积综合征(NICCD)和先天性胆管闭锁(BA)是婴儿肝炎综合征的2个常见原因。研究生化指标在BA和NICCD的诊断价值,以利于早期诊断。方法收集2008-12-01—2009-03-31在广州市儿童医院住院的临床诊断婴儿肝炎综合征(IHS)患儿77例,其中确诊BA28例,NICCD11例。选用患儿入院时的第一份生化检查结果,纳入指标为丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、谷酰转肽酶(γ-GT)、总胆红素(TB)、直接胆红素(DB)、总胆汁酸(TBA)、总胆固醇(TC),计算ALT/AST,ALP/γ-GT值。NICCD组还纳入血糖(GLU)、乳酸(LAC)、总蛋白(TP)、白蛋白(ALB)进行分析。应用SPSS10.0统计包对组间差异进行独立样本的t检验,并对有统计学差异的指标绘制ROC曲线。结果对于BA组,γ-GT、ALP/γ-GT的差异均存在统计学意义,且γ-GT>332.5U/L,ALP/γ-GT<1.93,有较高的诊断价值。NICCD组与其他非BA的IHS患儿比较,在GLU、LAC、TP、ALB、ALT/AST、γ-GT差异存在统计学意义。结论IHS患儿的生化指标对BA和NICCD的诊断有重要提示作用。
Objective To evaluate the value of biochemical markers in the diagnosis of biliary atresia （BA） and neonatal intrahepatic cholestasis caused by citrin deficiency （NICCD）. Methods Totally 77 infants in hospital with infantile hepatitis syndrome （IHS） were enrolled from December 1, 2008 to March 31, 2009. Totally 27 patients were diagnosed as having BA and 11 with NICCD. Biochemical markers were compared between groups including alanine transamiuase ALT, aspartate transaminase AST , alkaline phosphatase ALP, γ-glutamyl transpeptidase γ-GT, total bilirubin TB, direct bilirubin DB, total bile acid TBA, total cholesterol TC, to compute ALT/AST, ALP/γ-GT and glucose GLU, lactic acid LAC, total protein TP, albumin ALB in the NICCD group. The data were analyzed by T test and ROC curve with SPSS10.0. Results γ-GT was significantly elevated in the infants with BA when compared to non-BA group （P = 0.003） ; cut-off point was 332.SU/L. ALP/γ-GT was significantly lower in the patients with BA, and cut-off point was 1.93. The infants with NICCD had significantly different biochemical markers including GLU, LAC, TP, ALB, ALT/ AST and γ-GT. Conclusion Biochemical markers could be considered as complementary diagnosis of BA and NICCD for differentiating infants with IHS.
出处
《中国实用儿科杂志》
CSCD
北大核心
2009年第12期940-942,共3页
Chinese Journal of Practical Pediatrics
关键词
婴儿肝炎综合征
先天性胆管闭锁
新生儿
肝内胆汁淤积综合征
infantile hepatitis syndrome （IHS）
biliary atresia （BA）
neonatal intrahepatic cholestasis caused by citrin deficiency （NICCD）
diagnosis
