Zhen Chen, Guoliang Qiao, Lishuang Ma, Zhen Zhang, Chen Wang, Jun Zhang, Shuli Liu, Kaoping Guan, Chao Liu, Xuan Yang, Long Li
Department of Pediatric Surgery, Capital Institute of Pediatrics-Peking University Teaching Hospital, Yabao Road 2#, Chaoyang, Beijing, 100021, People's Republic of China.
Pediatr Surg Int. 2015 Jun;31(6):535-42. doi: 10.1007/s00383-015-3710-3. Epub 2015 Apr 18.
BACKGROUND/PURPOSE: The purpose of this study was to determine reliable predictors of outcome of biliary atresia (BA) after Kasai's operation.
This study included two consecutive stages of infants with biliary atresia. First stage, 200 BA cases who underwent Kasai's operation at our institution between May 2006 and May 2010 were retrospectively reviewed. In the first stage, we wanted to calculate a clinical scoring system by logistic regression. For cut-off determination, receiver operating characteristic (ROC) analysis was employed. Second stage (validation of scoring system), we used our scoring system to prospectively predict the outcomes of patients underwent a Kasai operation from inspecting the accuracy of our system.
Early cholangitis, age at operation, JC time, post-operative TB, DB, AST, ALT and surgical method entered into our scoring system. The most reliable cut-offs determined by ROC analysis were 7.71 (sensitivity: 86.0%, specificity: 98.0%). We used our scoring system to predict the prognosis of the 15 BA patients and found that 13 of 15 patients were correctly predicted at the cut-off value of 7.71.
Our scoring system is considered to be a reliable and useful predictor of the prognosis of biliary atresia.
背景/目的：本研究旨在确定Kasai手术后胆道闭锁（BA）预后的可靠预测指标。
本研究包括两个连续阶段的胆道闭锁婴儿。第一阶段，回顾性分析了2006年5月至2010年5月在我院接受Kasai手术的200例BA病例。在第一阶段，我们想通过逻辑回归计算一个临床评分系统。为了确定临界值，采用了受试者操作特征（ROC）分析。第二阶段（评分系统验证），我们使用我们的评分系统前瞻性地预测接受Kasai手术患者的预后，以检验我们系统的准确性。
早期胆管炎、手术年龄、黄疸持续时间（JC时间）、术后总胆红素（TB）、直接胆红素（DB）、谷草转氨酶（AST）、谷丙转氨酶（ALT）和手术方式纳入我们的评分系统。通过ROC分析确定的最可靠临界值为7.71（敏感性：86.0%，特异性：98.0%）。我们使用我们的评分系统预测15例BA患者的预后，发现在临界值7.71时，15例患者中有13例被正确预测。
我们的评分系统被认为是胆道闭锁预后的可靠且有用的预测指标。
