慢性乙型肝炎自然史阶段的误分类：中国儿童新ALT，AST，AKP

StephenW

Clin Chim Acta. 2018 Nov 29. pii: S0009-8981(18)30615-6. doi: 10.1016/j.cca.2018.11.034. [Epub ahead of print]
Misclassification of chronic hepatitis B natural history phase: Insight from new ALT, AST, AKP, and GGT reference intervals in Chinese children.
Chang Y1, Li H1, Ren H1, Xu H2, Hu P3.
Author information
Abstract
BACKGROUND:

The age- and sex-specific reference intervals (RIs) for liver chemistry in children are not available in China. Our study aimed to establish age and gender related RIs for ALT, AST, AKP, and GGT in China, and apply the new RI for ALT in children with chronic hepatitis B to use as a biochemical marker for disease progression.
METHODS:

Data were collected from the Children's Healthcare Center. The measurements of ALT, AST, AKP and GGT were performed on a Hitachi 7600 Chemistry Analyzer. Age- and sex-specific RIs were determined using a percentile (3rd-97th) method. The sensitivity and specificity were determined to test the ability of the newly proposed ALT thresholds to classify children with chronic HBV infection.
RESULTS:

The age- and sex-specific RIs of ALT, AST, AKP and GGT were established based on 4232 Chinese healthy children. Using the new median ALT threshold, the sensitivity was higher. The detection of chronic HBV infection was 31.2% in boys and 35.5% in girls, while a very slight decrease in specificity was found. Based on the newly proposed RIs of ALT, approximately 16.1% boys and 19.0% girls would be classified in the HBeAg-positive chronic hepatitis phase, but using the current ALT threshold of children's hospitals they were in HBeAg-positive chronic infection phase.
CONCLUSIONS:

Based on a large healthy population, we established the sex- and age-specific RIs of ALT, AST, AKP and GGT serum activities for Chinese children. Meanwhile, newly proposed liver chemistry RIs will benefit the understanding of liver function and the natural history of chronic HBV infection in children.

Copyright © 2018. Published by Elsevier B.V.
KEYWORDS:

Chronic hepatitis B; Liver chemistries; Pediatric; Reference intervals

PMID:
    30503274
DOI:
    10.1016/j.cca.2018.11.034

StephenW

Clin Chim Acta。 2018年11月29日.pii：S0009-8981（18）30615-6。 doi：10.1016 / j.cca.2018.11.034。 [提前打印]
慢性乙型肝炎自然史阶段的误分类：中国儿童新ALT，AST，AKP和GGT参考区间的分析。
Chang Y1，Li H1，Ren H1，Xu H2，Hu P3。
作者信息
抽象
背景：

中国没有儿童肝脏化学的年龄和性别特异性参考区间（RI）。我们的研究旨在确定中国ALT，AST，AKP和GGT的年龄和性别相关RI，并将新的RI用于慢性乙型肝炎患儿的ALT用作疾病进展的生化标志物。
方法：

数据来自儿童保健中心。 ALT，AST，AKP和GGT的测量在Hitachi 7600化学分析仪上进行。使用百分位数（第3-97）方法确定年龄和性别特异性RI。确定敏感性和特异性以测试新提出的ALT阈值对慢性HBV感染儿童进行分类的能力。
结果：

基于4232名中国健康儿童建立了ALT，AST，AKP和GGT的年龄和性别特异性RI。使用新的中位ALT阈值，灵敏度更高。慢性HBV感染的检测率在男孩中为31.2％，在女孩中为35.5％，但发现特异性略有下降。根据新提出的ALT RI，大约16.1％的男孩和19.0％的女孩将归入HBeAg阳性慢性肝炎阶段，但使用目前儿童医院的ALT阈值，他们处于HBeAg阳性慢性感染期。
结论：

基于大量健康人群，我们为中国儿童确定了性别和年龄特异性的ALT，AST，AKP和GGT血清活性RI。同时，新提出的肝脏化学RI将有助于了解儿童的肝功能和慢性HBV感染的自然史。

版权所有©2018。Elsevier B.V.
关键词：

慢性乙型肝炎;肝脏化学;儿科;参考区间

结论：
    30503274
DOI：
    10.1016 / j.cca.2018.11.034