Zhang Hongfei, Dong Yi, Wang Limin, Xu Zhiqiang, Chen Dawei, Gan Yu, Wang Fuchuan, Zhong Yanwei, Yan Jianguo, Zhu Shishu, Zhang Taihe
Pediatric Liver Disease Therapy and Research Center, People's Liberation Army(PLA) 302 Hospital, Beijing 100039, China.
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Zhonghua Er Ke Za Zhi. 2014 Aug;52(8):570-4.
To explore the pathological and clinical characteristics of children with liver diseases by retrospective study on clinical and liver biopsy pathological data of children with liver diseases.
This retrospective analysis was performed at Beijing No. 302 Hospital among 3 932 children with liver diseases who visited the hospital from January 2001 to December 2012. The kinds of diseases were compared with the results of 1983-2000.
(1) Liver biopsy was successful in 99.72% (3 932/3 943) of cases of 2001-2012 group, complications occurred in 31 children only. (2) Of the 3 932 cases, 2 647 (67.32%) had hepatitis , non-hepatotropic viral hepatitis and non viral liver disease were seen in 365 cases (9.28%), and 920 cases (23.4%), respectively. Among 2 647 cases with viral hepatitis, 2 115 were hepatitis B (79.90%), 521 hepatitis C (19.69%), 7 were hepatitis A (0.26%) and 4 hepatitis E (0.15%), respectively. (3) In 2001-2012 group, the degrees of inflammatory activity (>G2) of liver were seen in 9.57% (202/2 111) patients with hepatitis B, while 23.57% (132/560) in 1983-2000 group. There was significant difference between the two groups (χ(2)=80.36, P=0.00 ). (4) Significant difference was observed in the rate of non viral liver disease between 2001-2012 group (23.40%, 920/3 932) and 1983-2000 group (9.61%, 98/1 020) (χ(2)=93.46, P=0.00). In 2001-2012 group, including 46 kinds of diseases, which were significantly higher than those of 1983-2000 group (18 kinds). In 2000-2012, the main causes of diseases were liver degeneration (18.26%, 168/920), drug-induced liver injury (13.59%, 125/920), fatty liver (8.80%, 81/920) and liver glycogen accumulation disease (8.70%, 80/920). While in 1983-2000 group, the main causes were liver degeneration (20.41%, 20/98), fatty liver (16.33%, 16/98), glycogen storage disease (10.20%, 10/98) and myopathy (9.18%, 9/98).
Liver biopsy in children is safe and feasible. Hepatitis B virus was ranked first in children with liver diseases in 2001-2012 group. The kinds of non viral hepatic disorders had changed and extended.
通过对肝病患儿的临床及肝穿刺活检病理资料进行回顾性研究，探讨肝病患儿的病理及临床特征。
本回顾性分析在北京302医院进行，研究对象为2001年1月至2012年12月期间来该院就诊的3932例肝病患儿。将疾病种类与1983 - 2000年的结果进行比较。
（1）2001 - 2012年组3943例患儿中99.72%（3932/3943）肝穿刺活检成功，仅31例出现并发症。（2）3932例中，2647例（67.32%）为肝炎，非嗜肝病毒性肝炎和非病毒性肝病分别为365例（9.28%）和920例（23.4%）。2647例病毒性肝炎患儿中，乙型肝炎2115例（79.90%），丙型肝炎521例（19.69%），甲型肝炎7例（0.26%），戊型肝炎4例（0.15%）。（3）2001 - 2012年组乙型肝炎患儿肝脏炎症活动度（>G2）为9.57%（202/2111），1983 - 2000年组为23.57%（132/560）。两组间差异有统计学意义（χ(2)=80.36，P = 0.00）。（4）2001 - 2012年组非病毒性肝病发生率（23.40%，920/3932）与1983 - 2000年组（9.61%，98/1020）相比差异有统计学意义（χ(2)=93.46，P = 0.00）。2001 - 2012年组疾病种类有46种，明显高于1983 - 2000年组（18种）。2000 - 2012年，主要病因依次为肝变性（18.26%，168/920）、药物性肝损伤（13.59%，125/920）、脂肪肝（8.80%，81/920）和肝糖原累积病（8.70%，80/920）。而1983 - 2000年组主要病因为肝变性（20.41%，20/98）、脂肪肝（16.33%，16/98）、糖原贮积病（10.20%，10/98）和肌病（9.18%，9/98）。
儿童肝穿刺活检安全可行。2001 - 2012年组肝病患儿中乙型肝炎病毒感染居首位。非病毒性肝病的种类发生了变化且有所增加。
