高剂量类固醇不能改善胆道闭锁的早期预后。

High-dose steroids do not improve early outcome in biliary atresia.

作者信息

Vejchapipat Paisarn, Passakonnirin Rojjana, Sookpotarom Paiboon, Chittmittrapap Soottiporn, Poovorawan Yong

机构信息

Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.

出版信息

J Pediatr Surg. 2007 Dec;42(12):2102-5. doi: 10.1016/j.jpedsurg.2007.08.038.

DOI:10.1016/j.jpedsurg.2007.08.038

PMID:18082717

Abstract

PURPOSE

Our objective was to evaluate the effects of steroids on early outcome in biliary atresia (BA).

METHODS

Patients with BA between 2001 and 2005 were reviewed. The use of steroids (4 mg/kg per day at alternate days for 1 to 3 months) has been routinely implemented since 2003. Jaundice-free status and the occurrence of cholangitis at 6 months postoperatively between patients receiving steroids and those not receiving steroids were compared.

RESULTS

Fifty-three patients with BA were studied. At 6 months postoperation, 30 patients (56.6%) were jaundice free and 24 patients (45.3%) experienced cholangitis at least once. Of the 53 patients, there were 33 patients in the steroid group and 20 patients in the nonsteroid group. The proportion of jaundice-free patients in the steroid group was higher than that in the nonsteroid group, and the proportion of patients with cholangitis in the steroid group was lower than that in the nonsteroid group. However, these discrepancies did not reach a statistically significant difference (jaundice-free status [steroid vs nonsteroid]: 20/33 [60.6%] vs 10/20 [50%], P = .57; cholangitis: 13/33 [39.4%] vs 11/20 [55%], P = .39).

CONCLUSIONS

Although the use of steroids seems to have benefits, it did not statistically improve early outcome in patients with BA.

摘要

目的

我们的目标是评估类固醇对胆道闭锁（BA）早期预后的影响。

方法

回顾了2001年至2005年期间患有BA的患者。自2003年以来，常规使用类固醇（隔日4mg/kg，持续1至3个月）。比较了接受类固醇治疗的患者和未接受类固醇治疗的患者术后6个月时的无黄疸状态和胆管炎的发生情况。

结果

研究了53例BA患者。术后6个月时，30例患者（56.6%）无黄疸，24例患者（45.3%）至少经历过一次胆管炎。53例患者中，类固醇组有33例，非类固醇组有20例。类固醇组无黄疸患者的比例高于非类固醇组，类固醇组胆管炎患者的比例低于非类固醇组。然而，这些差异未达到统计学显著性差异（无黄疸状态[类固醇组与非类固醇组]：20/33[60.6%]对10/20[50%]，P = 0.57；胆管炎：13/33[39.4%]对11/20[55%]，P = 0.39）。