临床小儿外科杂志2024，Vol.23Issue(8)：723-728,6.DOI:10.3760/cma.j.cn101785-202405079-005
Ⅲ型胆道闭锁患儿术前基质金属蛋白酶水平与Kasai手术后预后的相关性研究
Prognostic value of preoperative serum levels of MMPs in children of biliary atresia
摘要
Abstract
Objective To explore the correlation between preoperative serum matrix metalloproteinases(MMPs)levels and liver fibrosis,as well as the jaundice clearance rate,early cholangitis,and medium-to-long-term native liver survival following the Kasai procedure in children with Type Ⅲ biliary atresia,in order to identify predictive factors for the prognosis of biliary atresia after Kasai surgery.Methods A retrospective a-nalysis was conducted on the preoperative serum MMPs protein levels of children diagnosed with Type Ⅲ biliary atresia who underwent the Kasai procedure at the Department of Neonatal Surgery,Children's Hospital,Zhe-jiang University School of Medicine,procedure from March 2017 to June 2018.Postoperative data included liver pathology,jaundice resolution at 3 months,early cholangitis,and 5-year native liver survival.Serum MMPs levels were analyzed in relation to different prognostic outcomes.Results A total of 38 children were included in this study,including 22 males and 16 females.3 children,diagnosed with Type Ⅲ biliary atresia intraop-eratively,had their families refuse the Kasai procedure and only underwent liver biopsy.Of the 35 patients who proceeded with the Kasai procedure and liver biopsy,6 underwent liver transplantation within 1 year post-surgery,2 died due to biliary atresia-related complications,and 27 survived with native liver for over 5 years.There were no statistically significant differences in preoperative serum MMPs levels between the jaun-dice resolution and non-resolution groups,or between the native liver survival and non-survival groups.How-ever,preoperative serum MMP-7 levels were significantly higher in the early cholangitis group(29 967.89±15 079.03 pg/mL)compared to the non-cholangitis group(15 071.77±10 988.75 pg/mL)(t=2.978,P＜0.05).For liver fibrosis,MMP-7 levels were higher in the severe fibrosis group[20 288.52(11 146.71,28 581.65)pg/mL]compared to the mild fibrosis group[9 103.31(4 603.54,16 759.18)pg/mL](Z=-2.285,P＜0.05).MMP-13 levels were lower in the severe fibrosis group[1 193.47(1 013.33,1 485.17)pg/mL]compared to the mild fibrosis group[1 396.81(1 295.41,1 748.79)pg/mL](Z=-1.972,P＜0.05).Conclusions Preoperative serum MMP-7 and MMP-13 levels are associated with early cholangitis and the degree of liver fibrosis after Kasai surgery in children with biliary atresia,and may as poten-tial prognostic markers.关键词
胆道闭锁/基质金属蛋白酶类/肝纤维化/黄疸/胆管炎/存活率/数据相关性Key words
Biliary Atresia/Matrix Metalloproteinases/Hepatic Fibrosis/Jaundice/Cholangitis/Sur-vival Rate/Correlation of Data引用本文复制引用
胡书奇,钭金法,韩一江,赵晓霞,方舒,赖登明,陈锐,黄寿奖,吕成杰,秦琪..Ⅲ型胆道闭锁患儿术前基质金属蛋白酶水平与Kasai手术后预后的相关性研究[J].临床小儿外科杂志,2024,23(8):723-728,6.基金项目
2020年度国家中心自主设计项目(SZOC0004) Independent Design Project of the National Center for the Year 2020(SZOC0004) （SZOC0004）
