婴儿期肝病临床特点分析

Clinical characteristics of infantile liver disease

目的分析婴儿期胆汁淤积性和非胆汁淤积性肝病的临床特点。方法回顾分析肝病婴儿的临床资料,比较胆汁淤积和非胆汁淤积肝病婴儿的临床差异。结果1985例肝病婴儿中,男性866例、女性1119例,入院月龄为(2.88±3.08)月。胆汁淤积症婴儿477例(24.0%),非胆汁淤积症婴儿1508例(76.0%)。单因素分析示,胆汁淤积婴儿的月龄小于非胆汁淤积婴儿,总胆红素、直接胆红素、γ-谷氨酰转肽酶、碱性磷酸酶、总胆汁酸水平高于非胆汁淤积婴儿,差异均有统计学意义(P<0.05)。多元logistic回归分析示,γ-谷氨酰转肽酶、碱性磷酸酶和总胆汁酸水平越高,月龄、白蛋白水平越低,发生胆汁淤积的可能性越高。结论在婴儿期,相比非胆汁淤积性肝病,胆汁淤积性肝病起病早,γ-谷氨酰转肽酶、碱性磷酸酶和总胆汁酸水平高。

Objective To explore the clinical characteristics of infantile cholestatic liver diseases and non-cholestatic liver diseases.Methods The clinical data of liver disease in infants were retrospectively analyzed,and the clinical differences between cholestatic and non-cholestatic liver disease in infants were compared.Results Among 1985 children(866 males and 1119 females)aged(2.88±3.088)months at admission,there were 477 cases(24.0%)of cholestasis,and 1508 cases(76.0%)of non-cholestasis.Univariate analysis showed that the age of cholestasis infants was younger than that in non-cholestasis infants,and the levels of total bilirubin,direct bilirubin,γ-glutamyltranspeptidase,alkaline phosphatase and total bile acid were higher than those in non-cholestasis infants.The differences were statistically significant(all P<0.05).Multivariate logistic regression analysis showed that with the higher levels ofγ-glutamyltranspeptidase,alkaline phosphatase and total bile acid,the age and albumin level were lower and the possibility of cholestasis was higher.Conclusions Compared with non-cholestatic liver disease in childhood,cholestatic liver disease has earlier onset and higher levels of gamma glutamyltranspeptidase,alkaline phosphatase and total bile acid,which may help the differentiation in clinic.