中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

胆道闭锁诊断方法的研究进展

孙溶涓 詹江华

引用本文:
Citation:

胆道闭锁诊断方法的研究进展

DOI: 10.3969/j.issn.1001-5256.2022.07.043
基金项目: 

新疆维吾尔自治区自然科学基金 (2019D01A12)

新疆维吾尔自治区自然科学基金 (2021D01A38)

利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:孙溶涓、詹江华共同起草及修改文章关键内容。
详细信息
    通信作者:

    詹江华,zhanjianghuatj@163.com

Research advances in the diagnostic methods for biliary atresia

Research funding: 

XinJiang Uygur Autonomous Region Science Foundation Proiect (2019D01A12);

XinJiang Uygur Autonomous Region Science Foundation Proiect (2021D01A38)

More Information
  • 摘要: 胆道闭锁患儿尽早、快速做出诊断,并及时进行手术干预,对提高其自体肝生存率至关重要。本文结合作者临床工作经验以及近年来最新研究进展,对快速诊断胆道闭锁的方法做一简要述评,分析对比不同诊断方式的优点与不足,为临床诊断思维的建立提供参考。

     

  • 图  1  BA快速诊断流程图

    Figure  1.  Flow chart of rapid diagnosis of biliary atresia

  • [1] Section of Hepatobiliary Surgery, Branch of Pediatric Surgery, Chinese Medical Association; Section of Pediatric Hepatic Transplantation, Branch of Organ Transplantation, Chinese Medical Doctor Association. Guidelines for diagnosing & treating biliary atresia (2018 Edition)[J]. J Clin Hepatol, 2019, 35(11): 2435-2440. DOI: 10.3760/cma.j.issn.0253-3006.2019.05.003.

    中华医学会小儿外科学分会肝胆外科学组, 中国医师协会器官移植医师分会儿童器官移植学组. 胆道闭锁诊断及治疗指南(2018版)[J]. 临床肝胆病杂志, 2019, 35(11): 2435-2440. DOI: 10.3760/cma.j.issn.0253-3006.2019.05.003.
    [2] SHINKAI M, OHHAMA Y, TAKE H, et al. Long-term outcome of children with biliary atresia who were not transplanted after the Kasai operation: > 20-year experience at a children's hospital[J]. J Pediatr Gastroenterol Nutr, 2009, 48(4): 443-450. DOI: 10.1097/mpg.0b013e318189f2d5.
    [3] KONG YY, ZHAO JQ, WANG J, et al. Modified stool color card with digital images was efficient and feasible for early detection of biliary atresia-a pilot study in Beijing, China[J]. World J Pediatr, 2016, 12(4): 415-420. DOI: 10.1007/s12519-016-0061-7.
    [4] XU XD, ZHAN JH. Differential diagnosis of surgical disorders associated with neonatal jaundice[J]. Chin Clin Dr, 2020, 48(2): 129-132. DOI: 10.3969/j.issn.2095-8552.2020.02.002.

    徐晓丹, 詹江华. 与新生儿黄疸相关外科疾病的鉴别[J]. 中国临床医生杂志, 2020, 48(2): 129-132. DOI: 10.3969/j.issn.2095-8552.2020.02.002.
    [5] FRANCISCOVICH A, VAIDYA D, DOYLE J, et al. PoopMD, a mobile health application, accurately identifies infant acholic stools[J]. PLoS One, 2015, 10(7): e0132270. DOI: 10.1371/journal.pone.0132270.
    [6] WANG J, QIAN T, JIANG J, et al. Gut microbial profile in biliary atresia: a case-control study[J]. J Gastroenterol Hepatol, 2020, 35(2): 334-342. DOI: 10.1111/jgh.14777.
    [7] POWELL JE, KEFFLER S, KELLY DA, et al. Population screening for neonatal liver disease: potential for a community-based programme[J]. J Med Screen, 2003, 10(3): 112-116. DOI: 10.1177/096914130301000303.
    [8] DONG C, ZHU HY, CHEN YC, et al. Clinical assessment of differential diagnostic methods in infants with cholestasis due to biliary atresia or non-biliary atresia[J]. Curr Med Sci, 2018, 38(1): 137-143. DOI: 10.1007/s11596-018-1857-6.
    [9] RENDÓN-MACÍAS ME, VILLASÍS-KEEVER MA, CASTAÑEDA-MUCIÑO G, et al. Improvement in accuracy of gamma-glutamyl transferase for differential diagnosis of biliary atresia by correlation with age[J]. Turk J Pediatr, 2008, 50(3): 253-259.
    [10] ZHOU K, WANG J, XIE G, et al. Distinct plasma bile acid profiles of biliary atresia and neonatal hepatitis syndrome[J]. J Proteome Res, 2015, 14(11): 4844-4850. DOI: 10.1021/acs.jproteome.5b00676.
    [11] SHANG XH, LU XM, DENG JT, et al. Diagnostic value of serum high molecular weight alkaline phosphatase in early detection of cholestatic jaundice in neonates[J]. Chin J Pediatr, 2003, 41(10): 747-750. DOI: 10.3760/j.issn:0578-1310.2003.10.008.

    商晓红, 卢宪梅, 邓景惕, 等. 血清大分子碱性磷酸酶测定对新生儿阻塞性黄疸早期诊断价值的研究[J]. 中华儿科杂志, 2003, 41(10): 747-750. DOI: 10.3760/j.issn:0578-1310.2003.10.008.
    [12] PEI JH, CHEN G, ZHENG S, et al. Diagnostic value of PIVKA-Ⅱ for biliary atresia and its correlations with liver functions[J]. J Clin Pediatr Surg, 2018, 17(11): 809-813. DOI: 10.3969/j.issn.1671-6353.2018.11.003.

    裴家好, 陈功, 郑珊, 等. PIVKA-Ⅱ对胆道闭锁的诊断价值及其与肝功能的相关性研究[J]. 临床小儿外科杂志, 2018, 17(11): 809-813. DOI: 10.3969/j.issn.1671-6353.2018.11.003.
    [13] DONG R, JIANG J, ZHANG S, et al. Development and validation of novel diagnostic models for biliary atresia in a large cohort of Chinese patients[J]. EBioMedicine, 2018, 34: 223-230. DOI: 10.1016/j.ebiom.2018.07.025.
    [14] YANG L, ZHOU Y, XU PP, et al. Diagnostic accuracy of serum matrix metalloproteinase-7 for biliary atresia[J]. Hepatology, 2018, 68(6): 2069-2077. DOI: 10.1002/hep.30234.
    [15] PENG X, YANG L, LIU H, et al. Identification of circulating MicroRNAs in biliary atresia by next-generation sequencing[J]. J Pediatr Gastroenterol Nutr, 2016, 63(5): 518-523. DOI: 10.1097/MPG.0000000000001194.
    [16] ZHAO JF, DOU R, ZHENG QP, et al. Expression and clinical significance of LECT2 in biliary atresia hepatic fibrosis[J]. Chin J Pediatr Surg, 2020, 41(7): 633-639. DOI: 10.3760/cma.j.cn421158-20200222-00110.

    赵金凤, 窦然, 郑启鹏, 等. 白细胞衍生趋化因子2在胆道闭锁肝纤维化中的表达及临床意义[J]. 中华小儿外科杂志, 2020, 41(7): 633-639. DOI: 10.3760/cma.j.cn421158-20200222-00110.
    [17] SUZUKI M, MURAJI T, OBATAKE M, et al. Urinary sulfated bile acid analysis for the early detection of biliary atresia in infants[J]. Pediatr Int, 2011, 53(4): 497-500. DOI: 10.1111/j.1442-200X.2010.03268.x.
    [18] EL-GUINDI MA, EL-SAID HH, HUSSEIN MH, et al. Urinary urobilinogen in biliary atresia: A missed, simple and cheap diagnostic test[J]. Hepatol Res, 2016, 46(2): 174-182. DOI: 10.1111/hepr.12558.
    [19] GOLDEN J, ZAGORY JA, FENLON M, et al. Liquid chromatography-mass spectroscopy in the diagnosis of biliary atresia in children with hyperbilirubinemia[J]. J Surg Res, 2018, 228: 228-237. DOI: 10.1016/j.jss.2018.03.021.
    [20] HWANG SM, JEON TY, YOO SY, et al. Early US findings of biliary atresia in infants younger than 30 days[J]. Eur Radiol, 2018, 28(4): 1771-1777. DOI: 10.1007/s00330-017-5092-5.
    [21] NAPOLITANO M, FRANCHI-ABELLA S, DAMASIO MB, et al. Practical approach to imaging diagnosis of biliary atresia, Part 1: prenatal ultrasound and magnetic resonance imaging, and postnatal ultrasound[J]. Pediatr Radiol, 2021, 51(2): 314-331. DOI: 10.1007/s00247-020-04840-9.
    [22] ZHOU LY, CHEN SL, CHEN HD, et al. Percutaneous US-guided cholecystocholangiography with microbubbles for assessment of infants with US findings equivocal for biliary atresia and gallbladder longer than 1.5 cm: a pilot study[J]. Radiology, 2018, 286(3): 1033-1039. DOI: 10.1148/radiol.2017170173.
    [23] WEI YY, CHEN Y, GAO T, et al. The diagnosyic value of GGT combined with ultrasound found gallbladder abnormality in infants with biliary atresia[J]. Chin J Gen Surg, 2017, 32(5): 425-428. DOI: 10.3760/cma.j.issn.1007-631X.2017.05.014.

    卫园园, 陈扬, 高婷, 等. 谷氨酰转肽酶测定联合超声诊断先天性胆道闭锁[J]. 中华普通外科杂志, 2017, 32(5): 425-428. DOI: 10.3760/cma.j.issn.1007-631X.2017.05.014.
    [24] CHEN XZ, GUAN YX, ZHANG Q, et al. Early diagnostic value of modified dynamic radionuclide hepatobiliary imaging combined with ultrasonography in congenital biliary atresia[J]. Chin J Med Imaging, 2021, 29(3): 240-243. DOI: 10.3969/j.issn.1005-5185.2021.03.012.

    陈学忠, 关晏星, 张青, 等. 改良法核素肝胆动态显像联合超声对先天性胆道闭锁的早期诊断[J]. 中国医学影像学杂志, 2021, 29(3): 240-243. DOI: 10.3969/j.issn.1005-5185.2021.03.012.
    [25] ZHOU W, YANG Y, YU C, et al. Ensembled deep learning model outperforms human experts in diagnosing biliary atresia from sonographic gallbladder images[J]. Nat Commun, 2021, 12(1): 1259. DOI: 10.1038/s41467-021-21466-z.
    [26] VERKADE HJ, BEZERRA JA, DAVENPORT M, et al. Biliary atresia and other cholestatic childhood diseases: Advances and future challenges[J]. J Hepatol, 2016, 65(3): 631-642. DOI: 10.1016/j.jhep.2016.04.032.
    [27] DESMET VJ. Ductal plates in hepatic ductular reactions. Hypothesis and implications. I. Types of ductular reaction reconsidered[J]. Virchows Arch, 2011, 458(3): 251-259. DOI: 10.1007/s00428-011-1048-3.
    [28] BABU RO, LUI V, CHEN Y, et al. Beta-amyloid deposition around hepatic bile ducts is a novel pathobiological and diagnostic feature of biliary atresia[J]. J Hepatol, 2020, 73(6): 1391-1403. DOI: 10.1016/j.jhep.2020.06.012.
    [29] OHNUMA N, TAKAHASHI T, TANABE M, et al. The role of ERCP in biliary atresia[J]. Gastrointest Endosc, 1997, 45(5): 365-370. DOI: 10.1016/s0016-5107(97)70145-7.
    [30] TSUDA N, SHIRAISHI S, SAKAMOTO F, et al. Tc-99m PMT scintigraphy in the diagnosis of pediatric biliary atresia[J]. Jpn J Radiol, 2019, 37(12): 841-849. DOI: 10.1007/s11604-019-00882-8.
    [31] SENÜZ OF, YEŞILDAǦ E, EMIR H, et al. Diagnostic laparoscopy in prolonged jaundice[J]. J Pediatr Surg, 2001, 36(3): 463-465. DOI: 10.1053/jpsu.2001.21621.
  • 加载中
图(1)
计量
  • 文章访问数:  526
  • HTML全文浏览量:  199
  • PDF下载量:  68
  • 被引次数: 0
出版历程
  • 收稿日期:  2022-01-09
  • 录用日期:  2022-02-18
  • 出版日期:  2022-07-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回