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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 Neonatal intrahepatic cholestasis syndrome (NICCD) and congenital biliary atresia (BA) are two common causes of infant hepatitis syndrome. To study the diagnostic value of biochemical indicators in BA and NICCD in order to facilitate early diagnosis. Methods A total of 77 children with clinical diagnosis of infant hepatitis syndrome (IHS) admitted to Children ’s Hospital of Guangzhou from December 2008 to January 2009 were enrolled. Among them, 28 cases were diagnosed as BA and 11 cases were NICCD. The first biochemical test results of children admitted to hospital were enrolled in the study. The indexes included ALT, AST, ALP, γ-GT Total bilirubin (TB), direct bilirubin (DB), total bile acid (TBA) and total cholesterol (TC) were calculated. ALT / AST and ALP / γ-GT were calculated. The NICCD group was also included in the analysis of GLU, LAC, TP and ALB. The SPSS10.0 statistical package was used to test the t-test of independent samples for the difference between groups, and the ROC curve was drawn for the statistically significant indexes. Results There was a statistically significant difference between the two groups in terms of γ-GT and ALP / γ-GT, with a higher diagnostic value for γ-GT> 332.5U / L and ALP / γ-GT <1.93. There were significant differences in GLU, LAC, TP, ALB, ALT / AST and γ-GT between NICCD group and other non-BA IHS children. Conclusion The biochemical indexes in children with IHS have an important role in the diagnosis of BA and NICCD.