|本期目录/Table of Contents|

[1]甘 雨,张 敏,朱世殊,等.2011—2017 年单中心儿童非病毒性肝病谱分析[J].传染病信息,2019,02:109-112.
 GAN Yu,ZHANG Min*,ZHU Shi-shu,et al.Analysis of children non-viral liver disease spectrum in single center from 2011 to 2017[J].Infectious Disease Information,2019,02:109-112.
点击复制

2011—2017 年单中心儿童非病毒性肝病谱分析(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2019年02期
页码:
109-112
栏目:
论 著
出版日期:
2019-05-15

文章信息/Info

Title:
Analysis of children non-viral liver disease spectrum in single center from 2011 to 2017
文章编号:
1007-8134(2019)02-0109-05
作者:
甘 雨张 敏朱世殊董 漪徐志强陈大为王丽旻王福川闫建国曹丽丽王 璞 李爱芹
100039 北京,中国人民解放军总医院第五医学中心青少年肝病诊疗与研究中心(甘雨、张敏、朱世殊、董漪、徐志强、陈大为、王丽旻、王福川、闫建国、曹丽丽、王璞、李爱芹)
Author(s):
GAN Yu ZHANG Min* ZHU Shi-shu DONG Yi XU Zhi-qiang CHEN Da-wei WANG Li-min WANG Fu-chuan YAN Jian-guo CAO Li-li WANG Pu LI Ai-qin
Pediatric Liver Disease Diagnosis and Treatment Center, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
关键词:
非病毒性肝病病理学基因质谱儿童
Keywords:
non-viral liver diseases pathology gene mass spectrometry children
分类号:
R725.7
DOI:
10.3969/j.issn.1007-8134.2019.02.003
文献标识码:
A
摘要:
目的 探讨单个儿童肝病中心非病毒性肝病的疾病谱及变化趋势。方法 收集2011 年1 月—2017 年12 月在我 院青少年肝病诊疗中心住院诊治的0 ~ 16 岁儿童非病毒性肝病患者数据,统计并分析其在同期收治的儿童肝病患者中的占 比、疾病谱及病种分布。并与1983 年6 月—2000 年12 月、2001 年1 月—2010 年12 月同类病例数据作比较。结果 2011 年 1 月—2017 年12 月儿童非病毒性肝病患者占同期儿童肝病患者总数的23.30%(925/3967),较2001 年1 月—2010 年12 月 的17.53%(703/4010)有所上升。2011 年1 月—2017 年12 月儿童非病毒性肝病疾病共72 种,病例中以药物性肝损害(31.0%) 最多,其次为肝豆状核变性(13.7%)和非酒精性脂肪性肝炎(11.0%);而2001 年1 月—2010 年12 月构成比前三名的疾病 为肝豆状核变性(22.62%)、药物性肝损害(10.53%)和糖原累积病(9.53%)。不同年龄段居于前三位的病种分别为,1 岁 以下:药物性肝损害(31.3%),糖原累积病(13.4%),胆汁淤积型肝病(11.9%)。1 ~ 6 岁:药物性肝损害(28.8%), 肝豆状核变性(16.8%),糖原累积病(12.2%)。7 ~ 16 岁:药物性肝损害(32.9%),非酒精性脂肪性肝炎(19.8%),肝 豆状核变性(12.5%)。儿童非病毒性肝病重叠病毒性肝炎的发生率为11.6%(107/925),值得关注。7.8%(72/925)的儿童 非病毒性肝病疑难病例通过基因检测等特殊检查得到确诊,但仍有2.9%(27/925)目前无法确诊。结论 近30 年来儿童非 病毒性肝病占比逐渐增多,药物性肝损害和非酒精性脂肪性肝病增长迅速。质谱基因检测技术的应用进一步扩展了疾病谱。
Abstract:
Objective To investigate the spectrum and change trend of non-viral liver disease in children from single center of pediatric liver disease. Methods We collected data of non-viral liver disease children aged from 0 to 16 years old who were admitted to the pediatric liver disease diagnosis and treatment center of our hospital from January 2011 to December 2017, analyzed the proportion of nonviral liver disease children in all liver disease children during the same period and investigated the spectrum and distribution of this disease. In addition, the data were compared with the data of non-viral liver disease children from June 1983 to December 2000 and from January 2001 to December 2010. Results From January 2011 to December 2017, children with non-viral liver disease accounted for 23.30% (925/3967) of children with liver disease in the same period. The proportion of children with non-viral liver disease increased, compared with that from January 2001 to December 2010 (17.53%, 703/4010). From January 2011 to December 2017, the spectrum of non-viral liver diseases in children included 72 diseases, predominantly drug-induced liver injury (31.0%), then Wilson’s disease (13.7%) and non-alcoholic fatty liver disease (11.0%). From January 2001 to December 2010, the top three diseases of non-viral liver diseases were Wilson's disease (22.62%), drug-induced liver injury (10.53%) and glycogen storage disease (9.53%). The top three diseases in different age groups were various. In 0-1 year old group, they were drug-induced liver injury (31.3%), glycogen storage disease (13.4%) and cholestasis liver disease (11.9%); in 1-6 years old group, they were drug-induced liver injury (28.8%), Wilson’s disease (16.8%) and glycogen storage disease (12.2%); in 7-16 years old group, they were drug-induced liver injury (32.9%), non-alcoholic fatty liver disease (19.8%) and Wilson’s disease (12.5%). The proportion of non-viral liver disease overlapping viral hepatitis in children was 11.6% (107/925), which deservesd attention. Through special tests such as gene detection, 7.8% (72/925) of intractable cases of non-viral liver diseases in children were diagnosed. However, 2.9% (27/925) intractable cases remained inconclusive. Conclusions During the past 30 years, the proportion of non-viral liver diseases in children has gradually increased. The rapid growth of drug-induced liver injury and non-alcoholic fatty liver diseases need to be paid attention. The application of gene mass spectrometry has facilitated the spectrum of non-viral liver diseases in children.  

参考文献/References


[1] 张鸿飞,杨晓晋,朱世殊,等. 1020 例小儿肝穿刺组织病理 学与临床的研究[J]. 中华儿科杂志,2002,40(3):131-134.
[2] 朱世殊,董漪,徐志强,等. 2001—2010 年儿童非病毒性肝 病谱分析[J]. 传染病信息,2011,24(5):279-281.
[3] Chalasani NP, Hayashi PH, Bonkovsky HL, et al. ACG clinical guideline: the diagnosis and management of idiosyncratic druginduced liver injury[J]. Am J Gastroenterol, 2014, 109(7):950- 966.
[4] 中华医学会肝病学分会药物性肝病学组. 药物性肝损伤 诊治指南(2015 年版)[J]. 临床肝胆病杂志,2015, 31(11):1752-1768.
[5] 甘雨,董漪,张鸿飞,等. 184 例儿童药物性肝损伤的临床特 征及转归状况评价[J]. 临床肝胆病杂志,2015,31(8):1244- 1247.
[6] Socha P, Janczyk W, Dhawan A, et al. Wilson’s disease in children: a position paper by the Hepatology Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [J]. J Pediatr Gastroenterol Nutr, 2018, 66(2):334-344.
[7] European Association for Study of Liver. EASL clinical practice guidelines: Wilson’s disease[J]. J Hepatol, 2012, 56(3):671- 685.
[8] Vos MB, Abrams SH, Barlow SE, et al. NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children[J]. J Pediatr Gastroenterol Nutr, 2017, 64(2):319-334.
[9] Nobili V, Vajro P, Dezsofi A, et al. Indications and limitations of bariatric intervention in severely obese children and adolescents with and without nonalcoholic steatohepatitis: ESPGHAN Hepatology Committee Position Statement[J]. J Pediatr Gastroenterol Nutr, 2015, 60(4):550-561.
[10] 周雪莲,傅君芬. 儿童非酒精性脂肪肝病诊断与治疗专家共 识[J]. 中国实用儿科杂志,2018,33(7):487-492.
[11] Mieli-Vergani G, Vergani D, Baumann U, et al. Diagnosis and management of paediatric autoimmune liver disease: ESPGHAN Hepatology Committee Position Statement[J]. J Pediatr Gastroenterol Nutr, 2018, 66(2):345-360.
[12] European Association for the Study of the Liver. EASL clinical practice guidelines: the diagnosis and management of patients with primary biliary cholangitis[J]. J Hepatol, 2017, 67(1):145-172.
[13] Fawaz R, Baumann U, Ekong U, et al. Guideline for the evaluation of cholestatic jaundice in infants: joint recommendations of the North American Society for pediatric gastroenterology, hepatology, and nutrition (NASPGHAN) and the European Society for pediatric gastroenterolog, hepatology, and nutrition[J]. J Pediatr Gastroenterol Nutr, 2017, 64(1):154-168.
[14] Kishnani PS, Austin SL, Abdenur JE, et al. Diagnosis and management of glycogen storage disease type I: a practice guideline of the American College of Medical Genetics and Genomics[J]. Genet Med, 2014, 16(11):e1.
[15] 朱启镕,王建设. 婴儿胆汁淤积症的鉴别诊断思路[J]. 临 床肝胆病杂志,2011,21(7):679-693.
[16] 中华医学会肝病学分会. 胆汁淤积性肝病诊断和治疗共识 (2015)[J]. 中国肝脏病杂志,2015,23(12):924-933.
[17] Turck D, Braegger CP, Colombo C, et al. ESPEN-ESPGHANECFS guidelines on nutrition care for infants, children, and adults with cystic fibrosis[J]. Clin Nutr, 2016, 35(3):557-577.
[18] European Association for the Study of the Liver. EASL clinical practice guidelines: vascular diseases of the liver[J]. J Hepatol, 2016, 64(1):179-202.
[19] Mohty M, Malard F, Abecassis M, et al. Sinusoidal obstruction syndrome/veno-occlusive disease: current situation and perspectives-a position statement from the European Society for Blood and Marrow Transplantation (EBMT)[J]. Bone Marrow Transplant, 2015, 50(6):781-789.
[20] 王建设,朱启镕. Citrin 缺陷病的诊治[J]. 临床肝胆病杂志, 2011,27(7):700-702.
[21] 中华医学会肝病学分会. 感染乙型肝炎病毒的育龄女性临床 管理共识[J]. 中国病毒病杂志,2018,8(3):164-169.
[22] Dezs?fi A, Baumann U, Dhawan A, et al. Liver biopsy in children position paper of the ESPGHAN hepatology committee[J]. J Pediatr Gastroenterol Nutr, 2015, 60(3):408-420.

备注/Memo

备注/Memo:
[ 基金项目] 首都临床特色应用研究(Z61100000516176)
[ 通信作者] 张敏,E-mail: gcmw2001@163.com
*Corresponding author, E-mail: gcmw2001@163.com
更新日期/Last Update: 2019-05-15