甲胎蛋白和其他血生化指标构建潜在的胆道闭锁患儿早期诊断模型.

BACKGROUND: Biliary atresia is not suitable as a method for early diagnosis because it mainly depends on intraoperative diagnosis, and the operation is complicated, and there is a great injury to the child. Therefore, finding simple and effective blood biochemical diagnostic indicators will improve early diagnosis efficiency.OBJECTIVE: To measure the plasma alpha-fetoprotein level in children with biliary atresia and to investigate the application value of plasma alpha-fetoprotein level and blood biochemical indicators.METHODS: Blood samples were harvested from 48 infants with biliary atresia, 20 infants with neonatal hepatitis, and 9 healthy controls.Plasma alpha-fetoprotein level was measured by enzyme-linked immunosorbent assay. The correlation between plasma alpha-fetoprotein level and blood biochemical indicators was analyzed to establish a potential diagnosis model. This study was approved by the Ethics Committee of Xinhua Hospital, China(approval No. XHEC-D-2013-026).RESULTS AND CONCLUSION: Plasma alpha-fetoprotein level in infants with biliary atresia and neonatal hepatitis was significantly higher than that in the healthy controls(P < 0.001), but no significant difference in plasma alpha-fetoprotein level was observed between infants with biliary atresia and neonatal hepatitis(P > 0.05). There was no significant difference in plasma alpha-fetoprotein level between infants with different stages of cirrhosis(P > 0.05). Blood biochemical indexes indicated severe liver injury in infants with biliary atresia and neonatal hepatitis. There were significant differences in plasma prealbumin(P < 0.05) and γ-glutaminyl transpeptidase levels between infants with biliary atresia and neonatal hepatitis(P < 0.01). Plasma alpha-fetoprotein level was negatively correlated with γ-glutaminyl transpeptidase level(r =-0.516, P < 0.01). A potential diagnosis model was established based on plasma alpha-fetoprotein, prealbumin,γ-glutaminyl transpeptidase levels, age and sex of infant patients, with a sensitivity of 81.82%, specificity of 91.67%, and area under the curve of 0.939. Results suggest that plasma alpha-fetoprotein level increased in infants with biliary atresia. Establishing a diagnosis model based on blood biochemical indicators such as plasma alpha-fetoprotein is of certain reference value for clinical diagnosis of biliary atresia. [ABSTRACT FROM AUTHOR]