El-Hawary Manal A, El-Raziky Mona S, Esmat Gamal, Soliman Hanan, Abouzied Amr, El-Raziky Maissa, El-Akel Wafaa, El-Sayed Rokaya, Shebl Fatma, Shaheen Abdel-Aziz, El-Karaksy Hanaa
Department of Pediatrics, Fayoum University, Dokki, Cairo, Egypt.
World J Gastroenterol. 2007 May 28;13(20):2846-51. doi: 10.3748/wjg.v13.i20.2846.
To assess hepatic fibrosis and factors associated with its progression in children with HCV infection.
At the Hepatology Unit, Cairo University Children's Hospital, a single liver biopsy was performed to 43 children with HCV infection after an informed consent between 1998-2004. Their mean age at liver biopsy was 8.67 +/- 4.3 years.
Among the 43 patients' biopsies, 12 (27.9%) were having no fibrosis, 20 (46.5%) mild fibrosis and 11 (25.6%) moderate to severe fibrosis. The median time for development of fibrosis was estimated to be 5.5 years. Developing fibrosis was significantly associated with shorter duration from first detected ALT elevation to biopsy (12 mo vs 1.2 mo, P=0.015) and having higher levels of direct serum bilirubin (0.3 mg/dL vs 0.5 mg/dL, P=0.048). No association was found between fibrosis stage and the presence of co-morbid conditions (P=0.33).
Hepatic fibrosis was present in 72.1% of children with HCV infection. The development of fibrosis was associated with higher levels of direct serum bilirubin. There was no significant association between fibrosis and age, duration of infection, risk factors, co-morbid conditions and most biochemical parameters.
评估丙型肝炎病毒（HCV）感染儿童的肝纤维化情况及其进展相关因素。
在开罗大学儿童医院肝病科，于1998年至2004年间，在获得知情同意后，对43例HCV感染儿童进行了单次肝活检。他们肝活检时的平均年龄为8.67±4.3岁。
在43例患者的活检中，12例（27.9%）无纤维化，20例（46.5%）为轻度纤维化，11例（25.6%）为中度至重度纤维化。纤维化发展的中位时间估计为5.5年。纤维化的发展与首次检测到ALT升高至活检的时间较短（12个月对1.2个月，P = 0.015）以及血清直接胆红素水平较高（0.3mg/dL对0.5mg/dL，P = 0.048）显著相关。未发现纤维化阶段与合并症的存在之间存在关联（P = 0.33）。
72.1%的HCV感染儿童存在肝纤维化。纤维化的发展与血清直接胆红素水平较高有关。纤维化与年龄、感染持续时间、危险因素、合并症及大多数生化参数之间无显著关联。
