摘要
目的探讨谷氨酰转肽酶联合超声对胆道闭锁（biliaryatresia，BA）的诊断价值。方法回顾性分析梗阻性黄疸患儿69例，其中BA组55例，非BA组（Non-BA）14例。诊断均经术中造影证实。收集两组患者术前实验室检查和超声检查各指标，比较其灵敏度（sensitivity，Se），特异度（specificity，Sp），阳性预测值（positivepredictivevalue，＋PV），阴性预测值（negative predictivevalue，-PV）及准确度（accuracy）。结果BA组GGT高于Non-BA组（t=-4．164，P〈0．05）。以GGT〉306U／L诊断BA时Se、Sp、＋Pv、-PV及准确度分别为69．1％、92．9％、97．4％、43．3％及73．9％。BA组和Non-BA组超声检查中胆囊异常情况比较差异有统计学意义（χ2=9．995，P〈0．05），其诊断BA的准确度为78．3％，其诊断BA的se、sp、＋PV、-PV、准确度分别为83．6％、57．1％、88．5％、47．1％、78．3％。GGT和胆囊异常两者联合诊断BA的Se、Sp、＋PV、-PV为92．7％、92．9％、98．1％、76．5％。准确度为92．8％。结论对于梗阻性黄疸的患儿，当GGT〉306U／L，腹部超声提示胆囊异常者，应尽早行术中造影以明确是否存在胆道闭锁。
Objective To evaluate GGT in combination with B ultrasound for the diagnosis of biliary atresia （BA） infants suffering from obstructive jaundice. Methods A retrospective analysis was made on 69 sick infants including 55 BAs and 14 non-BAs as identified by intraoperative cholangiography. The preoperative laboratory GGT and ultrasound data were collected and analyzed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were compared. Results BA patients had significantly higher GGT than Non-BA patients （ t = - 4. 164, P 〈 0. 05 ）. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of GGT 〉 306 U/L were 69. 1%, 92.9%, 97.4%, 43.3%, 73.9%, respectively. In BA group, abnormal gallbladder was significantly associated with proadening portal vein, broadening hepatic artery compared with Non-BA patients （χ2 =9. 995, P 〈0. 05）. The accuracy of abnormal gallbladder on ultrasound was 78.3%. When two method combined for the diagnosis of BA, the sensitivity, specificity, positive predictive value, negative predictive value were 92.7%, 92.9%, 98. 1% and 76. 5% and accuracy can reach 92.8% . Conclusions For obstructive jaundice infants with GGT 〉 306 U/L and abdominal gallbladder ultrasound finding intraoperative cholangiography should be carried out to make definite diagnosis of BA.
出处
《中华普通外科杂志》
CSCD
北大核心
2017年第5期425-428,共4页
Chinese Journal of General Surgery
基金
天津市卫生行业重点攻关基金资助项目（14KG129）：天津市卫生局重点基金资助项目（2014KR09）
国家自然科学基金资助项目（81570471）
关键词
黄疸
梗阻性
超声检查
胆道闭锁
Jaundice, obstructive
Uhrasonography
Bliliary atresia
