[1]裴家好,陈功,郑珊,等. PIVKA-Ⅱ对胆道闭锁的诊断价值及其与肝功能的相关性研究[J].临床小儿外科杂志,2018,17(11):809-813.
　Pei Jiahao,Chen Gong,Zheng Shan,et al. Diagnostic value of PIVKA-Ⅱfor biliary aresia and its correlations with liver functions.[J].Journal of Clinical Pediatric Surgery,2018,17(11):809-813.
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 PIVKA-Ⅱ对胆道闭锁的诊断价值及其与肝功能的相关性研究

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第17卷 期数: 2018年11期 页码: 809-813 栏目: 专题讨论 出版日期: 2018-11-20
Title:
 Diagnostic value of PIVKA-Ⅱfor biliary aresia and its correlations with liver functions.
作者:
 裴家好; 陈功; 郑珊; 等.
 复旦大学附属儿科医院外科
Author(s):
 Pei Jiahao; Chen Gong; Zheng Shan; Dong Kuiran; Dong Rui.
 Department of Surgery,Affiliated Childrens Hospital,Fudan University;Shanghai Municipal Key Laboratory of Preventing & Treating Birth Defects,Shanghai 201102,China.
关键词:
 ; 胆道闭锁;  异常凝血酶原;  胆汁淤积
Keywords:
 ; Biliary Atresia;  PIVKA-Ⅱ;  Cholestasis
文献标志码:
A
摘要:
 目的初步探讨PIVKAⅡ对胆道闭锁的诊断价值及其与肝功能各项指标间的相关性。方法以复旦大学附属儿科医院2016年7月至2017年3月收治的131例因梗阻性黄疸入院且术中诊断为胆道闭锁的患儿为研究对象。选取排除胆道闭锁的胆汁淤积症患儿及同年龄段行臂丛神经损伤修复手术且肝功能正常的患儿作为对照组，测定各组的血清PIVKAⅡ含量并进行统计分析。结果3组患儿PIVKAⅡ水平分别为：胆道闭锁组29.39(19.29~173.80)mAU/mL；胆汁淤积组22.59(18.20~38.34)mAU/mL；肝功能正常组24.77(21.01~29.20)mAU/mL。胆道闭锁组患儿血清PIVKAⅡ含量比其他两组更高（P<0.05）；PIVKAⅡ在对胆道闭锁及胆汁淤积进行鉴别诊断时，敏感性与特异性分别为97.67%和35.11%；PIVKAⅡ含量在不同性别组中比较无统计学差异（P>0.05）；各年龄段胆道闭锁患儿PIVKAⅡ水平无统计学差异（P>0.05）；PIVKAⅡ与γ谷氨酰转移酶、胆红素、肝功能、白蛋白之间无统计学相关性（P>0.05）；PIVKAⅡ与各凝血功能指标之间亦无统计学相关性（P＞0.05）。结论梗阻性黄疸患儿普遍存在PIVKAⅡ水平异常，其中胆道闭锁患儿PIVKAⅡ水平升高更为显著，有一定鉴别意义，或可将PIVKAⅡ作为术前诊断胆道闭锁的参考指标。
Abstract:
 ObjectiveTo explore the diagnostic value of PIVKAⅡ for biliary aresia (BA) and its correlation with liver functions.MethodsFrom July 2016 to March 2017,a total of 131 patients with obstructive jaundice were collected.Basic profiles and preoperative serum were collected for testing the value of PIVKAⅡ.ResultsThe level of PIVKAⅡ was 29.39 (19.29~173.80) mAU/mL in BA group,22.59 (18.20~38.34) mAU/mL in cholestasis group and 24.77(21.01~29.20) mAU/mL in normal liver function group.Significant differences existed among three groups.And the serum level of PIVKAⅡ in BA children was higher than that of another two groups (P<0.05).In the differential diagnosis of PIVKAⅡ between groups of BA and cholestasis,the sensitivity and specificity of diagnosing were 97.67% and 35.11% respectively.No significant difference existed in PIVKAⅡ level between boys and girls with BA（P>0.05).And no significant difference existed in PIVKAⅡ level among BA children of all ages（P>0.05）.PIVKAⅡ and gammaglutamyl transferase,bilirubin,liver function,albumin showed no correlation（P>0.05）.No statistically significant correlation existed between PIVKAⅡ and coagulatory function.ConclusionBA Children with obstructive jaundice has widespread anomalies of PIVKAⅡ level.It may be used as a reference index of preoperative diagnosis of BA.

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更新日期/Last Update: 2018-11-23