胆道闭锁诊断及预后相关血清学检测指标研究进展

Recent advances in the study of serological test parameters related to the diagnosis and prognosis of biliary atresia

胆道闭锁(biliary atresia,BA)是一种进行性、特发性、纤维闭塞性胆管病,预后较差,严重危及患儿生命,至今病因不明。BA诊断的金标准是术中的胆道造影,属于有创性检查。临床中急需灵敏度、特异度高,易于操作的诊断方法和预后评估方法。目前胆红素、基质金属蛋白酶-7、γ-谷氨酰转肽酶在BA诊断方面的价值已经得到广泛的认同,但白细胞介素-33、β-淀粉样蛋白、自体调节蛋白、微小RNA、Mac-2结合蛋白糖基化异构体、生长因子等新兴血清学检测指标与BA诊断、肝纤维化和Kasai术后自体肝生存的关系还有待于进一步研究。本文拟从BA诊断相关血清学检测指标、BA肝纤维化相关血清学检测指标、BA患儿Kasai术后自体肝生存相关血清学检测指标3个方面对相关文献进行综述,以期为BA的诊疗提供依据。

As a progressive,idiopathic and fibrous occlusive bile duct disease with a poor prognosis,biliary atresia(BA)poses a serious risk to the survival.The underlying cause of BA has remained unknown.A gold standard for diagnosing BA is invasive intraoperative cholangiography.Diagnostic and prognostic tools with a high level of sensitivity and specificity and convenient handling are urgently needed in clinical practices.The diagnostic values of bilirubin,matrix metalloproteinase-7 andγ-glutamyl transpeptidase for BA have been widely recognized.However,the relationship between such emerging serological tests as interleukin-3,β-amyloid,autotaxin,micro-RNA,M2BPGi,growth factors and diagnosis,hepatic fibrosis and native liver survival should be further examined.This review summarized the relevant literatures from three aspects of serological test parameters related to BA diagnosing,liver fibrosis and native liver survival after Kasai surgery to provide clinical rationales for properly managing BA.