胆道闭锁无创诊断现状与研究进展

Recent advances in noninvasive diagnosis of biliary atresia in early stage

胆道闭锁(biliary atresia,BA)是新生儿梗阻性黄疸的常见原因,其病理特征为肝外或肝内胆管的炎症及进行性肝纤维化。如能早期诊断,可显著减少并发症,改善患者预后。因此BA的早期诊断极为重要。目前BA诊断的金标准是术中胆道造影及肝组织病理活检,该诊断方法有创,且常需高年资医生作出判断。寻找灵敏度、特异度高,无创,可定量的早期诊断方法尤为迫切。本文围绕大便比色卡,粪便、尿液、血液来源标记物及影像学检查等无创诊断方法的研究进展进行综述,以期为临床诊疗工作提供参考。

As a common cause of neonatal obstructive jaundice,biliary atresia(BA)is characterized by inflammation and progressive fibrosis of extrahepatic or intrahepatic bile ducts.An early diagnosis may significantly improve the prognosis of children and lower the incidence of complications.Therefore an early diagnosis of BA is particularly important.Currently the gold standards for diagnosing BA are intraoperative cholangiography and liver pathological biopsy.Such a diagnostic mode is invasive and often requires the judgment of senior doctors.Thus it is imperative to seek a non-invasive and quantitative tool with high sensitivity and specificity.This review summarized the latest researches in the diagnostic efficacy of BA through stool colorimetric cards,stool,urine,blood-derived markers and imaging studies to provide rationales for clinical diagnosis and treatment.