Total bile acid concentration in duodenal fluid is a useful preoperative screening marker to rule out biliary atresia.
Total bile acid concentration in duodenal fluid is a useful preoperative screening marker to rule out biliary atresia.
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十二指肠液中的总胆汁酸浓度是排除胆道闭锁的有用的术前筛查标志物。
DOI：
10.1097/mpg.0000000000002037
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发表时间：
2018
影响因子：
2.9
通讯作者：
Ozono K
中科院分区：
文献类型：
--
作者：
Fukuoka T;Bessho K;Tachibana M;Satomura Y;Konishi A;Yasuda K;Kimura T;Hasegawa Y;Ueno T;Miyoshi Y;Ozono K
目的：十二指肠管试验（DTT）用于术前筛查，以排除胆道闭锁（BA）。在以前的报告中，DTT是通过十二指肠液的颜色来评估的，但没有定量标准。本研究的目的是检查DTT的疗效的基础上的总胆汁酸（TBA）浓度在十二指肠fluid.Methods：这是一个单中心的回顾性研究的婴儿胆汁淤积谁接受DTT从2008年至2016年在大坂大学医院。十二指肠液中最大TBA（dTBA），dTBA/血清TBA比值（sTBA），和dTBA/血清γ-谷氨酰转肽酶（sGGT）比值的截止值进行了评估的准确性排除BA。结果：共37名婴儿被纳入本研究，16名婴儿BA和21名婴儿与其他原因的肝内胆汁淤积症。dTBA敏感性为100%，特异性为90.5%，临界值为16.8 μmol/L。dTBA/sTBA比值（临界值：0.088）的特异性进一步提高至95.2%，dTBA/sGGT比值（临界值：0.076 μmol/U）的特异性进一步提高至100%。入院后0.8±1.4天即可进行DTT。结论：用dTBA、dTBA/sTBA比值、dTBA/sGGT比值评价DTT对BA的诊断准确性高，可避免部分患儿不必要的手术。
Objectives:Duodenal tube test (DTT) is used as a preoperative screening to rule out biliary atresia (BA). In previous reports, DTT was assessed by the color of the duodenal fluid, but there were no quantitative criteria. The aim of this study was to examine the efficacy of DTT based on the total bile acid (TBA) concentration in duodenal fluid.Methods:This is a single-center retrospective study of infants with cholestasis who underwent DTT from 2008 to 2016 at the Osaka University Hospital. The cut-off values of maximum TBA in duodenal fluid (dTBA), dTBA/serum TBA ratio (sTBA), and dTBA/serum gamma-glutamyl transpeptidase (sGGT) ratio were assessed for the accuracy in excluding BA.Results:A total of 37 infants were included in this study; 16 infants with BA and 21 infants with other causes of intrahepatic cholestasis. dTBA demonstrated sensitivity of 100% and specificity of 90.5% with the cut-off value of 16.8 μmol/L. Specificity was further improved to 95.2% with dTBA/sTBA ratio (cut-off value: 0.088) and 100% with dTBA/sGGT ratio (cut-off value: 0.076 μmol/U). DTT could be performed 0.8±1.4 days after admission. Hypoglycemia was developed in 1 infant.Conclusions:DTT evaluated by dTBA, dTBA/sTBA ratio, and dTBA/sGGT ratio had high accuracy to rule out BA and could avoid unnecessary surgery in some infants.