Development and validation of bile acid profile-based scoring system for identification of biliary atresia: a prospective study
Development and validation of bile acid profile-based scoring system for identification of biliary atresia: a prospective study
复制标题
用于识别胆道闭锁的基于胆汁酸谱的评分系统的开发和验证：一项前瞻性研究
DOI：
10.1186/s12887-020-02169-8
复制
发表时间：
2020-05-27
期刊：
影响因子：
2.4
通讯作者：
Zhang, Yongjun
中科院分区：
文献类型：
--
作者：
Zhao, Dongying;Zhou, Kejun;Zhang, Yongjun
早期鉴别胆道闭锁与其他原因引起的婴儿胆汁淤积仍然是一个重大挑战。我们的目的是开发和验证一个基于胆汁酸的评分系统，用于识别胆道闭锁MethodsIn一项前瞻性研究中，共141例胆汁淤积症的婴儿从2014年到2018年被纳入两组（推导队列，n= 66;验证队列，n= 75）。在推导队列中选择胆道闭锁和非胆道闭锁婴儿之间具有显著差异的变量。然后，包括这些变量的评分系统的设计和validation.ResultsAmong 66例患者的衍生队列，34（51.5%）有胆道闭锁。提出了一个评分系统，包括以下变量：甘氨鹅去氧胆酸/鹅去氧胆酸、粘土粪便和γ-谷氨酰转移酶。总评分范围为0 ~ 41分，以15分为界值，确定胆道闭锁，受试者工作特征曲线下面积为0.87（95%可信区间，0.77-0.94），衍生队列的敏感性为85.3%，特异性为81.3%;结论该简易评分系统对胆汁淤积症患儿胆道闭锁的诊断有较好的准确性。
BackgroundEarly distinguishing biliary atresia from other causes of infantile cholestasis remains a major challenge. We aimed to develop and validate a scoring system based on bile acid for identification of biliary atresia.MethodsIn a prospective study, a total of 141 infants with cholestasis were enrolled in two sets (derivation cohort,n= 66; validation cohort,n= 75) from 2014 to 2018. Variables with significant difference between biliary atresia and non-biliary atresia infants were selected in the derivation cohort. Then, a scoring system including those variables was designed and validated.ResultsAmong 66 patients in the derivation cohort, 34 (51.5%) had biliary atresia. A scoring system was proposed with the following variables: glycochenodeoxycholic acid/chenodeoxycholic acid, clay stool, and gamma-glutamyl transferase. The total score ranged from 0 to 41, and a cutoff value of 15 identified biliary atresia with an area under receiver operating characteristic curve of 0.87 (95% confidence interval, 0.77–0.94), sensitivity of 85.3%, and specificity of 81.3% in the derivation cohort; these values were also confirmed in a validation cohort with a sensitivity of 90.0% and specificity of 80.0%.ConclusionsThe proposed simple scoring system had good diagnostic accuracy for estimating the risk of biliary atresia in infants with cholestasis.