婴儿肝炎综合征222例病因分析

Etiological analysis of infantile hepatitis syndrome in 222 cases

目的：分析222例婴儿肝炎综合征的病因及临床特点,针对常见病因行相关检查,以协助临床早期诊断和治疗.方法：收集2005年1月至2009年7月本院儿科诊治的222例婴儿肝炎综合征患儿的临床各项检测资料（实验室检查、肝胆B超、核素扫描、肝活检等）进行回顾性分析.结果：222例婴儿肝炎综合征惠儿中男女比例约为2：1,发病年龄以1～3月多见,有163例占73.4%.本组婴儿肝炎综合征患儿的病因,以巨细胞病毒（CMV）肝炎有84例占37.8%、先天性胆管闭锁有82例占36.9%为主,其次为遗传代谢性疾病有14例占6.3%,其他病因的婴儿肝炎综合征有20例占9.0%,另有原因未明婴儿肝炎综合征有22例占9.9%.结论：本组婴儿肝炎综合征的病因构成依次为CMV肝炎、先天性胆道闭锁、遗传代谢性疾病.对婴儿肝炎综合征患儿应尽早行常见相关病毒学检测及肝胆B超、核素等检查.

Objective：Analyze the cause and clinical features of infantile hepatitis syndrome in 222 cases and do correlated examinations to commonly encountered cause of disease so as to help making early diagnosis and performing proper treatment. Method： We retrospectively analyzed the clinical data （laboratory examination, B ultrasound over liver and gallbladder, radioisotope scanning, liver biopsy, etc） of 222 infants with infantile hepatitis syndrome in our hospital from January 2005 to July 2009. Result： The male female ratio was about 2 ： 1 in the 222 cases. Ages of onset mainly were one to three month,accounting for 73：4% （163/222）. The most common causes were eytomegalovirus （CMV） hepatitis accounting for 37.8% （84/222） and congenital biliary atresia for 36.9% （82/222）. Hereditary metabolic diseases accounted for 6.3% （14/222）. Other causes accounted for 9.0% （20/ 222） ,besides, there were uncertain causes accounting for 9.9% （22/222）. Conclusion：The causes of infantile hepatitis syndrome in our research were cytomegalovirus hepatitis, congenital biliary atresia and hereditary metabolic diseases in turn. Correlative virological examination ,liver and gallbladder B ultrasound and nuclide examination are suggested to take as early as possibly for patients with infantile hepatitis syndrome.