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目的:探讨宁夏地区婴儿肝炎综合征的病因及预后特点。方法:选择2007年1月～2012年1月该院儿科收住的婴儿肝炎综合征165例,入院后全部行甲、乙、丙、丁、戊肝抗体,病毒全套、血培养、EB-IgM、梅毒联检、腹部B超、放射性核素胆道显像,部分患儿(26例)外送血尿标本行串联质谱分析以明确病因,并同时给予保肝退黄及相应的病因学治疗。结果:130例为感染所致(占78.8%),其中巨细胞病毒感染107例,败血症25例,乙肝病毒感染3例,梅毒1例,弓形虫感染1例,疱疹病毒感染2例;手术证实肝内外胆管异常10例(占6.1%),其中胆道闭锁8例,胆总管囊肿2例;代谢性疾病5例;病因不明21例。结论:婴儿肝炎综合征病因多种多样,其中感染占第1位,尤其巨细胞病毒感染已成为婴儿肝炎综合征的首位原因,单纯感染引起的婴儿肝炎综合征大多预后好,胆道闭锁是次常见病因,需早期诊断及早手术,代谢性疾病及病因不明者预后较差。
Objective: To investigate the etiology and prognosis of infant hepatitis syndrome in Ningxia. Methods: One hundred and sixty-five infants with hepatitis syndrome admitted to the hospital from January 2007 to January 2012 were enrolled. After admission, all patients were challenged with A, B, C, D and E antibody, complete virus, blood culture, EB-IgM , Syphilis joint examination, abdominal B ultrasound, radionuclide biliary imaging, some children (26 cases) outside the blood samples sent to determine the cause of tandem mass spectrometry, and at the same time give liver protection yellow and the corresponding etiological treatment. Results: 130 cases were caused by infection (78.8%), including 107 cases of cytomegalovirus infection, 25 cases of sepsis, 3 cases of hepatitis B virus infection, 1 case of syphilis, 1 case of Toxoplasma gondii infection and 2 cases of herpes simplex virus infection. Intrahepatic and extrahepatic bile duct abnormalities in 10 cases (6.1%), including biliary atresia in 8 cases, 2 cases of common bile duct cysts; Metabolic disease in 5 cases; etiology in 21 cases. Conclusion: The causes of infantile hepatitis syndrome are diverse, of which the infection is the No.1, especially the cytomegalovirus infection has become the first cause of infantile hepatitis syndrome. Most of the infantile hepatitis syndrome caused by simple infection has a good prognosis and biliary atresia is common Etiology, early diagnosis and early surgery, metabolic diseases and etiology of unknown prognosis is poor.