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婴儿肝外胆道闭销(EHBA)现已基本明确为获得性疾病,它不是单纯的发育畸形,而是感染过程引起的进行性纤维化,使胆道闭锁。目前,感染因素主要集中在病毒学领域,研究较深入但仍有争议的是呼肠病毒和轮状病毒。动物模型与电镜技术均提示呼肠病毒与EHBA有关,但是呼肠病毒抗原的研究结果均为阴性。因此,呼肠病毒作为EHBA的病因仍缺乏明确的证据。有学者应用聚合酶链反应(PCR)技术检测了2例确诊为EHBA患儿的肝活检标本和粪便标本,使用了A组轮状病毒的特异性引物,结果均为阴性:同样标本用C组轮状病毒特异性引物进行PCR扩增,结果均为阳性。此外,通过免疫电镜方法显示了C组轮状抗体恢复期较急性期有四倍以上升高,而A组轮状病毒均未显示有意义的特异性抗体水平变化。因此,C组轮状病毒引起胆道闭锁的可能性极大。
Infant extrahepatic biliary obstruction (EHBA) is now basically clear for acquired disease, it is not a simple developmental deformity, but the process of infection caused by progressive fibrosis, biliary atresia. At present, infectious agents are mainly concentrated in the field of virology. Readers who are still more controversial are reovirus and rotavirus. Both animal models and electron microscopy suggested that reovirus was associated with EHBA, but reovirus antigen results were negative. Therefore, the etiology of reovirus as EHBA still lacks clear evidence. Some scholars using polymerase chain reaction (PCR) technology detected 2 cases of liver biopsy specimens and stool specimens of children diagnosed with EHBA, the use of group A rotavirus specific primers, the results were negative: the same group with C group Rotavirus-specific primers for PCR amplification, the results were positive. In addition, immunoelectron microscopy showed that the recovery period of C-arm rotavirus was more than four times higher than that of the acute phase, but none of A-rotavirus showed any significant change of specific antibody. Therefore, C group of rotavirus bile atresia is very likely.