TBil、APRI联合GGT/Alb比值对胆道闭锁患儿肝纤维化严重程度的诊断价值  

Diagnostic value of TBil,APRI combined with GGT/Alb ratio for the severity of liver fibrosis in children with biliary atresia

作　　者：路景绍 耿宪杰 孙忠源[1] 陈姝璇 LU Jing-shao;GENG Xian-jie;SUN Zhong-yuan(Department of General Surgery,Children′s Hospital Affiliated of Zhengzhou University/Henan Children′s Hospital/Zhengzhou Children′s Hospital,Zhengzhou,450018,China)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院普通外科,河南郑州450018

出　　处：《中西医结合肝病杂志》2024年第9期795-797,802,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：河南省医学科技攻关联合共建项目(No.LHGJ20220740)。

摘　　要：目的:探讨总胆红素(TBil)、天冬氨酸氨基转移酶/血小板比值指数(APRI)联合γ-谷氨酰转肽酶(GGT)/白蛋白(Alb)比值在诊断胆道闭锁(BA)患儿肝纤维化严重程度中的价值。方法:选取2021年9月至2023年9月于郑州大学附属儿童医院确诊且住院手术的BA患儿120例为研究对象,依据肝纤维化严重程度分为<F2期组和≥F2期组,记录患儿一般资料及临床指标。结果:≥F2期组患儿TBil、APRI、GGT/Alb比值、天冬氨酸氨基转移酶(AST)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-Col)、透明质酸(HA)、层黏蛋白(LN)显著高于<F2期组患儿(P<0.05)。BA患儿TBil、APRI、GGT/Alb比值与AST、PCⅢ、Ⅳ-Col、HA、LN均呈正相关(P<0.05)。TBil、APRI、GGT/Alb比值是BA患儿发生明显肝纤维化的独立危险因素(OR=2.939、2.873、2.895,P<0.05)。TBil、APRI、GGT/Alb比值单独及联合诊断的曲线下面积分别为0.837、0.841、0.851、0.956。结论:TBil、APRI、GGT/Alb比值联合在诊断BA患儿肝纤维化程度方面具有重要价值。Objective:To explore the value of total bilirubin(TBil),aspartate aminotransferase,and platelet ratio index(APRI)combined with glutamyltranspeptidase(GGT)/albumin(Alb)ratio in diagnosing the severity of liver fibrosis in children with biliary atresia(BA).Methods:A total of 120 BA patients diagnosed and hospitalized for surgery in Zhengzhou University Affiliated Children′s Hospital from September 2021 to September 2023 were regarded as the study subjects.They were separated into<F2 stage group and≥F2 stage group based on the severity of liver fibrosis,the general information and clinical indicators of the patient were recorded.Results:The TBil,APRI,GGT/Alb ratio,aspartate aminotrans-ferase(AST),procollagenⅢ(PCⅢ),CollagenⅣ(ⅣCol),hyaluranic acid(HA),and laminin(LN)in≥F2 stage group were obviously higher than those in<F2 stage group(P<0.05).There was a positive correlation between TBil,APRI,GGT/Alb ratio and AST,PCⅢ,ⅣCool,HA and LN in BA patients(P<0.05).TBil,APRI,and GGT/ALb ratio were independent risk factors for obvious liver fibrosis in children with BA(O r=2.939,2.873,2.895,P<0.05).The area under the curve for individual and combined diagnosis of TBil,APRI,and GGT/Alb ratio was 0.837,0.841,0.851,and 0.956.Conclusion:The combination of TBil,APRI,and GGT/ALb ratio has important value in diagnosing the degree of liver fibrosis in children with BA.

关 键 词：胆道闭锁 肝纤维化 总胆红素 天冬氨酸氨基转移酶/血小板比值指数 γ-谷氨酰转肽酶/白蛋白比值 

分 类 号：R725.7[医药卫生—儿科]