Suzuki Mitsuyoshi, Muraji Toshihiro, Obatake Masayuki, Nio Masaki, Ito Kiichi, Suzuki Ken, Ota Kunitaka, Maisawa Shunichi, Yamashiro Yuichiro, Shimizu Toshiaki
Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan.
Pediatr Int. 2011 Aug;53(4):497-500. doi: 10.1111/j.1442-200X.2010.03268.x.
Measurement of urinary sulfated bile acid (USBA) is a non-invasive method to detect bile congestion. Our aim was to evaluate the feasibility of USBA analysis for the early detection of biliary atresia (BA).
We determined the USBA-to-creatinine ratio (USBA/cr) in 1148 infants at 10-40 days after birth. All infants were followed until the 3- to 4-month postnatal routine health check. The cutoff value for USBA/cr was 55.0 µmol/g creatinine.
Among the infants tested, 47 (4.10%) had USBA/cr ratios that exceeded the cutoff value. Two of these 47 infants had liver disease; one was diagnosed with neonatal hepatitis syndrome, and the other was diagnosed with BA. The BA patient underwent USBA analysis for the first time on day 18 after birth and hepatoportoenterostomy on day 49. No other infants were diagnosed with hepatobiliary disease during the follow-up period.
This USBA analysis provided the correct assessment without fail and identified a case of BA. This approach could be used for the screening and early detection of BA when the false-positive rate is decreased by improving the methods for sample collection and urine storage.
尿硫酸化胆汁酸（USBA）的测定是检测胆汁淤积的一种非侵入性方法。我们的目的是评估USBA分析在早期检测胆道闭锁（BA）方面的可行性。
我们测定了1148名出生后10至40天婴儿的USBA与肌酐比值（USBA/cr）。所有婴儿均随访至出生后3至4个月的常规健康检查。USBA/cr的临界值为55.0 μmol/g肌酐。
在接受检测的婴儿中，47名（4.10%）的USBA/cr比值超过临界值。这47名婴儿中有2名患有肝脏疾病；1名被诊断为新生儿肝炎综合征，另1名被诊断为BA。这名BA患者在出生后第18天首次接受USBA分析，并在第49天接受了肝门空肠吻合术。在随访期间，没有其他婴儿被诊断患有肝胆疾病。
这种USBA分析无一例外地提供了正确的评估，并确诊了1例BA。当通过改进样本采集和尿液储存方法降低假阳性率时，这种方法可用于BA的筛查和早期检测。
