临床小儿外科杂志2024，Vol.23Issue(12)：1155-1159,5.DOI:10.3760/cma.j.cn101785-202310018-009
多指标联合检测在胆总管囊肿和囊肿型胆道闭锁早期鉴别诊断中的应用价值
Application value of multi-index combined detection in early differential diagnosis of choledochal cyst and cystic biliary atresia
摘要
Abstract
Objective To explore the application value of biochemical indicators and combined multi-in-dex detection in an early differential diagnosis of choledochal cyst(CC)and cystic biliary atresia(CBA).Methods A retrospective analysis was conducted on the clinical data of 99 infants under 45 days of age with hepatic hilar cysts,treated from January 2013 to December 2022 at the Pediatric Surgery Department of Jining Medical University Affiliated Hospital and General Surgery Department of Capital Institute of Pediatrics Affilia-ted Children's Hospital.Based upon cholangiographic and pathological results,they were assigned into two groups of CBA and CC.The differences in biochemical parameters between two groups were compared.And the diagnostic effectiveness of single biochemical parameters and multi-index co-prediction models was analyzed by receiver operating characteristic curve(ROC).Results CBA group was composed of 37 cases(11 males and 26 females)with a median operative age of 26(18,37)days.And CC group included 62 cases(14 males and 48 females)with a median operative age of 23(13,35)days.No statistically significant inter-group differences existed in gender distribution or operative age(P＞0.05).Preoperative level of γ-glutamyl transferase(GGT)were 456.2(294.0,647.5)U/L in CBA group and 385.6(220.9,611.2)U/L in CC group;aspartate amin-otransferase(AST)level was 85.2(42.9,145.1)U/L in CBA group and 57.1(36.6,105.5)U/L in CC group;alanine aminotransferase(ALT)was 45.6(16.6,91.2)U/L in CBA group and 29.4(15.2,59.3)U/L in CC group.The inter-group differences were not statistically significant(P＞0.05).However,total bilirubin(TBIL)was 191.8(156.4,227.1)pmol/L in CBA group and 152.5(104.3,200.6)μmol/L in CC group;di-rect bilirubin(DBIL)66.7(41.0,97.1)μmol/L in CBA group and 47.3(21.8,70.8)μmol/L in CC group;total bile acid(TBA)91.4(62.1,114.8)μmol/L in CBA group and 61.9(17.5,91.1)μmol/L in CC group.The inter-group differences were statistically significant(P＜0.05).The areas under the ROC curve for TBIL,DBIL,TBA and weighted/unweighted prediction model were 0.658,0.677,0.712,0.752 and 0.782,respec-tively.Conclusions TBA,TBIL and DBIL have some values in the differential diagnosis of CC and CBA.And co-detection of multiple parameters offers a higher detection performance for facilitating an early postnatal differ-ential diagnosis of CBA and CC.关键词
胆总管囊肿/囊肿型胆道闭锁/γ-谷氨酰转移酶/天门冬氨酸氨基转移酶/谷丙转氨酶/总胆红素/直接胆红素/总胆汁酸/诊断,鉴别Key words
Choledochal Cyst/Cystic Biliary Atresia/gamma-Glutamyltransferase/Aspartate Aminotrans-ferase/Alanine Aminotransferase/Total Bile Acid/Direct Bilirubin/Total Bile Acid/Diagnosis,Differential引用本文复制引用
王提学,封林,孙明璇,田宇,李龙,孙劲松..多指标联合检测在胆总管囊肿和囊肿型胆道闭锁早期鉴别诊断中的应用价值[J].临床小儿外科杂志,2024,23(12):1155-1159,5.基金项目
中国医学科学院创新单元(2021RU015) （2021RU015）
首都临床诊疗技术研究及示范应用(Z191100006619002) Innovation Unit,Chinese Academy of Medical Sciences(2021RU015) （Z191100006619002）
Capital Clinical Treatment Technology Research & Demonstration Project(Z191100006619002) （Z191100006619002）
