瞬时弹性成像技术联合血清γ-谷氨酰转移酶对胆道闭锁患儿的诊断价值  

Diagnostic Value of Transient Elastography Combined with Serumγ-Glutamyl Transferase in Children with Biliary Atresia

作　　者：朱莹莹[1] 耿荷红 万园园[1] 燕林 赵欢欢[1] 张现伟 ZHU Yingying;GENG Hehong;WAN Yuanyuan;YAN Lin;ZHAO Huanhuan;ZHANG Xianwei(Department of General Surgery,Children’s Hospital of Henan Province,Children’s Hospital of Zhengzhou University,Zhengzhou Children’s Hospital,Zhengzhou 450018,China)

机构地区：[1]河南省儿童医院、郑州大学附属儿童医院、郑州儿童医院普通外科二病区,河南郑州450018

出　　处：《河南医学研究》2025年第6期1009-1012,共4页Henan Medical Research

基　　金：河南省医学科技攻关联合共建项目(LHGJ20220771,LHGJ20220772)。

摘　　要：目的探讨瞬时弹性成像技术联合血清γ-谷氨酰转移酶评估胆道闭锁患儿的诊断价值。方法选取2019年3月至2021年3月于河南省儿童医院普通外科就诊的88例怀疑为非感染性胆汁淤积性肝病患儿作为研究对象,其中胆汁淤积患儿20例,胆道闭锁患儿68例,所有患儿接受组织病理活检确诊,收集患儿术前瞬时弹性成像技术检测的肝硬度值(LSM)与患儿血常规、血生化等实验室指标。采用独立样本t检验进行计数资料组间比较。应用受试者工作特征曲线分析肝硬度值和血清学指标对胆道闭锁和胆汁淤积患儿肝纤维化程度的诊断效能。结果胆道闭锁患儿的LSM和血清γ-谷氨酰转移酶均高于胆汁淤积性肝病患儿且差异有统计学意义(P<0.05)。受试者工作特征曲线分析显示,术前利用LSM诊断胆道闭锁肝纤维化,其受试者工作特征曲线下面积为0.849,截断值为8.91 kPa,高于利用血清γ-谷氨酰转移酶诊断胆道闭锁肝纤维化的效能。术前二者独立诊断效能均小于LSM值联合血清γ-谷氨酰转移酶指标区分胆汁淤积性肝病与胆道闭锁的效能。结论瞬时弹性成像技术联合血清γ-谷氨酰转移酶对胆道闭锁患儿肝纤维化的诊断效能高于单独使用瞬时弹性成像技术或血清γ-谷氨酰转移酶,为临床胆道闭锁患儿肝纤维化的鉴别与诊断提供有利依据。Objective To explore the diagnostic value of combination of transient elastography and serum γ-glutamyl transferase in evaluating children with biliary atresia.Methods From March 2019 to March 2021,88 children with suspected noninfectious cholestatic liver disease were selected from the Department of General Surgery of Children’s Hospital of Henan Province,including 20 children with cholestasis and 68 children with biliary atresia.All children were diagnosed by histopathological biopsy.The liver stiffness measurement(LSM),blood routine laboratory indicators such as blood biochemistry.Use independent sample t-test for inter group comparison of counting data.Using receiver operating characteristic curves to analyze the diagnostic efficacy of liver hardness values and serological indicators on the degree of liver fibrosis in children with biliary atresia and cholestasis.Results The LSM and serum γ-glutamyl transferase levels in children with biliary atresia were higher than those in children with cholestatic liver disease,and the differences were statistically significant(P<0.05).The receiver operating characteristic analysis showed that the area under the receiver operating characteristic was 0.849 and the cut off value was 8.91 kPa when LSM was used to diagnose biliary atresia and hepatic fibrosis before surgery,which was higher than the efficacy of serum γ-glutamyl transferase in diagnosing biliary atresia and hepatic fibrosis.The independent diagnostic efficacy of both before operation was less than LSM value and the efficacy of serumγ-glutamyl transferase index in distinguishing cholestatic liver disease and biliary atresia.Conclusion The diagnostic efficacy of transient elastography combined with serumγ-glutamyl transferase for liver fibrosis in children with biliary atresia is higher than that of transient elastography alone or serum γ-glutamyl transferase,providing a favorable basis for the differentiation and diagnosis of liver fibrosis in children with biliary atresia in clinical practice.

关 键 词：胆道闭锁 瞬时弹性成像技术 Γ-谷氨酰转移酶 肝硬化 

分 类 号：R657.44[医药卫生—外科学]