胆管板畸形对胆道闭锁患儿自体肝生存的影响

The impact of ductal plate malformation on autologous liver survival in children with biliary atresia

目的分析胆管板畸形(DPM)与胆道闭锁(BA)患儿自体肝生存的关系。方法收集2008年1月—2017年12月在天津市儿童医院行Kasai手术,在天津市第一中心医院行肝移植(LT)的BA患儿40例。对Kasai术及LT时的肝组织进行HE染色及CK19免疫组化染色,按照不同时期DPM存在情况进行分组,Kasai术时无DPM组(27例),有DPM组(13例);LT时无DPM组(17例),有DPM组(23例)。分别比较不同阶段各组患儿自体肝生存时间差异。结果Kasai术时有DPM组和无DPM组BA患儿自体肝生存时间分别为230.0(190.5,276.5)d和336.0(218.0,757.0)d;LT时有DPM组和无DPM组BA患儿自体肝生存时间分别为230.0(185.0,285.0)d和527.0(288.0,817.0)d。无论是Kasai术还是LT时,有DPM患者的自体肝生存时间均较无DPM明显缩短(P<0.05)。结论胆道闭锁患儿伴发胆管板畸形可能会影响到自体肝生存时间。

Objective To analyze the relationship between bile ductal plate malformation(DPM)and autologous liver survival in children with biliary atresia(BA).Methods A total of 40 BA children underwent Kasai operation in Tianjin Children’s Hospital and liver transplantation(LT)in Tianjin First Central Hospital from January 2008 to December 2017 were collected.Hepatic tissue samples at the time of Kasai operation and liver transplantation were stained with HE and CK19 immunohistochemistry.According to the existence of DPM in different periods during Kasai operation,patients were divided into without DPM group(n=27)and with DPM group(n=13),and without DPM group(n=17)and with DPM group(n=23)during liver transplantation.The differences of autologous liver survival time were compared between different stage groups of children.Results The autologous liver survival time was 230.0(190.5,276.5)d and 336.0(218.0,757.0)d respectively in BA children with and without DPM during Kasai operation.The autologous liver survival time was 230.0(185.0,285.0)d and 527.0(288.0,817.0)d respectively in BA children with and without DPM during liver transplantation.The autologous liver survival time was significantly shorter in patients with DPM than that in patients without DPM either during Kasai operation or LT(P<0.05).Conclusion Children with biliary atresia associated with bile ductal plate malformation can shorten their autologous liver survival time.