活检证实的幼儿肝硬化：一项为期十年的队列研究

StephenW

Biopsy-proven liver cirrhosis in young children: A 10-year cohort study
Yi Dong  1 , Aiqin Li  1 , Shishu Zhu  1 , Weibin Chen  2 , Meina Li  3 , Pan Zhao  1
Affiliations
Affiliations

    1
    The Fifth Medical Center (formerly Beijing 302 Hospital), Chinese PLA General Hospital, Beijing, 100039, China.
    2
    Beijing Yunsheng Science & Technology Co.,Ltd, Beijing, 100041, China.
    3
    Department of Health Service, Second Military Medical University, Shanghai, 200433, China.

    PMID: 33763932 DOI: 10.1111/jvh.13501

Abstract

Young children with liver cirrhosis have a significantly high risk of mortality. However, there are few studies regarding early childhood-onset cirrhosis. This study aims to explore the causes, clinical findings and prognosis of biopsy-proven LC in infants, toddlers and preschoolers. We enrolled young children with biopsy-proven cirrhosis from January 2010. Till January 2020, the study has been going on for 10 years. A total of 139 cirrhotic children were enrolled, including 87 boys and 52 girls. The median age at initially histological diagnosis of cirrhosis was 2 years old (range: 1 month-6 years). Sixty-two patients reported yellowish discoloration of sclera and/or skin as an initial symptom. Ninety-three patients had definite etiologies while 46 had indeterminate causes. Among the confirmed cases, 31 had hepatitis B virus (HBV) infection, accounting for 33.3%. Subsequently, glycogen storage disease was diagnosed in 16 cases and Wilson disease in 14 cases. In these patients with HBV infection, 9 finally achieved hepatitis B surface antigen (HBsAg) loss (29.0%) after effective antiviral therapy during the follow-up. Logistic regression revealed that baseline alanine aminotransferase (odds ratio 1.008, P=0.028) was the independent predictor of HBsAg loss. Furthermore, 1 patient who underwent second biopsies showed histological reverse. HBV infection is an important cause of paediatric cirrhosis in our study. The Ppathogenesis of HBV-related cirrhosis in early childhood deserves further studies.

Keywords: children; infants; liver cirrhosis.

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StephenW

活检证实的幼儿肝硬化：一项为期十年的队列研究
易东1，李爱琴1，朱世叔1，陈伟彬2，李美娜3，潘昭1
隶属关系
隶属关系

    1个
    中国人民解放军总医院第五医疗中心（原北京302医院），北京100039。
    2个
    北京运升科技有限公司，北京100041
    3
    第二军医大学卫生服务系，上海200433。

    PMID：33763932 DOI：10.1111 / jvh.13501

抽象的

患有肝硬化的幼儿有很高的死亡风险。但是，关于儿童早期肝硬化的研究很少。本研究旨在探讨经活检证实的婴儿，幼儿和学龄前儿童LC的原因，临床发现和预后。我们从2010年1月开始招募经活检证实为肝硬化的幼儿。到2020年1月，这项研究已经进行了10年。共有139名肝硬化儿童入组，包括87名男孩和52名女孩。最初经组织学诊断为肝硬化的中位年龄为2岁（范围：1个月至6岁）。 62位患者报告巩膜和/或皮肤发黄变色为最初症状。病因明确的有93例，病因不明的有46例。在确诊病例中，乙型肝炎病毒感染31例，占33.3％。随后，诊断出糖原贮积病16例，威尔逊病14例。在这些HBV感染患者中，有9例在随访期间经过有效的抗病毒治疗后最终达到了乙型肝炎表面抗原（HBsAg）丢失（29.0％）的目标。 Logistic回归分析显示基线丙氨酸氨基转移酶（比值1.008，P = 0.028）是HBsAg丢失的独立预测因子。此外，1例接受了第二次活检的患者表现出组织学逆转。在我们的研究中，HBV感染是小儿肝硬化的重要原因。幼儿期HBV相关性肝硬化的发病机制值得进一步研究。

关键词：儿童；儿童婴儿肝硬化。

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