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目的探讨半乳糖凝集素-3(Gal-3)、透明质酸(HA)与胆道闭锁(BA)患儿术后肝损害、肝纤维化的关系。方法选择行Kasai术术后BA患儿为BA组(n=35),同期体检健康儿童为健康对照组(n=10)。BA组根据胆红素水平分为黄疸组(n=11)和无黄疸组(n=24),根据胃镜下食管静脉曲张情况分为门静脉高压(PH)组(n=27)和非PH组(n=8)。应用自动生化仪检测2组肝功能,采用ELISA检测2组血清Gal-3水平,采用放射免疫法检测2组血清HA水平。结果 BA组肝损害、肝纤维化程度较健康对照组重,血清Gal-3、HA水平均较健康对照组显著升高(Pa<0.05);黄疸组肝损害、肝纤维化程度较无黄疸组重,血清Gal-3、HA水平均较无黄疸组显著升高(Pa<0.05);无黄疸组血清Gal-3水平较健康对照组显著升高(P<0.05);PH组血清Gal-3水平较非PH组显著升高(P<0.05);血清Gal-3水平与总胆红素、ALT、γ-谷氨酸转肽酶水平呈正相关(Pa<0.05),与HA水平亦呈正相关(P<0.05)。结论血清Gal-3水平与BA术后患儿肝损害程度和肝纤维化程度密切相关,可作为BA术后判断患儿预后的重要生化指标。
Objective To investigate the relationship between liver damage and hepatic fibrosis in children with gallbladder leukolectasis (Gal-3), hyaluronic acid (HA) and biliary atresia (BA). Methods The patients with BA were selected as BA group (n = 35) after Kasai surgery and the healthy children in the same period were selected as healthy control group (n = 10). BA group was divided into jaundice group (n = 11) and jaundice group (n = 24) according to bilirubin level. According to the esophagogastric varices under endoscopy, the BA group was divided into PH group (n = 27) (n = 8). Two groups of liver function were detected by automatic biochemical analyzer. Serum Gal-3 levels were measured by ELISA and serum HA level by radioimmunoassay. Results The liver damage and hepatic fibrosis in BA group were heavier than those in healthy control group. The levels of Gal-3 and HA in serum of BA group were significantly higher than those in healthy control group (P <0.05). Compared with non-jaundice group, Serum Gal-3 and HA levels were significantly higher than those without jaundice (P <0.05), serum Gal-3 level was significantly higher in non-jaundice group than that in healthy control group (P <0.05) (P <0.05). The level of Gal-3 in serum was positively correlated with total bilirubin, ALT and γ-glutamic acid transpeptidase (P <0.05), and positively correlated with the level of HA (P <0.05). Conclusion Serum Gal-3 levels are closely related to the degree of liver damage and the degree of liver fibrosis in children with BA, which can be used as an important biochemical index to judge the prognosis of children after BA.