Wu Xin, DU Xiao-Rang, Ding Jin-Fang, Wu Meng-Jin, Luo Sheng-Qiang, Feng Xing-Zhong
Department of Traditional Chinese Medicine, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2016 Apr;18(4):335-9. doi: 10.7499/j.issn.1008-8830.2016.04.011.
To compare the clinical features of children with different clinical forms of congenital hepatic fibrosis (CHF), and provides a description of the characteristics of childhood CHF.
Sixty children with CHF between January 2002 and June 2015 were enrolled, including 26 children with portal hypertensive CHF (PH CHF), 3 children with cholangitic CHF, 30 children with combined portal hypertensive and cholangitic CHF (mixed CHF), and 1 child with latent forms of CHF. The medical data of 26 children with PH CHF and 30 children with mixed CHF, including gender, age, clinical manifestations, physical signs, laboratory tests and imaging characteristics, were retrospectively studied.
Fever, jaundice and hepatomegaly were more frequently noted in children with mixed CHF than in those with PH CHF (P<0.05). Splenomegaly and liver cirrhosis occurred more often in children with CHF, but there was no significant difference in the incidences of splenomegaly and liver cirrhosis between the children with PH CHF and mixed CHF. The plasma prothrombin activity, white blood cell counts, platelet counts, mean platelet volume, serum levels of alanine transaminase, aspartate transaminase, alkaline phosphatase, γ-glutamyl transferase, leucine aminopeptidase, and total bile acids in children with mixed CHF were higher than in those with PH CHF (P<0.05). The decreased international normalized ratio and lower serum albumin levels were more frequently observed in children with mixed CHF than in those with PH CHF (P<0.05).
PH and mixed CHF are common forms in childhood CHF. The children with the two forms of PH usually manifest portal hypertension such as cirrhosis and hepatosplenomegaly. The liver damage may be common in children with mixed CHF.
比较不同临床类型先天性肝纤维化(CHF)患儿的临床特征,并描述儿童CHF的特点。
纳入2002年1月至2015年6月期间的60例CHF患儿,其中门静脉高压型CHF(PH CHF)26例、胆管炎型CHF 3例、门静脉高压合并胆管炎型CHF(混合型CHF)30例、隐匿型CHF 1例。回顾性研究26例PH CHF患儿和30例混合型CHF患儿的医学资料,包括性别、年龄、临床表现、体征、实验室检查及影像学特征。
混合型CHF患儿发热、黄疸、肝肿大的发生率高于PH CHF患儿(P<0.05)。脾肿大和肝硬化在CHF患儿中更常见,但PH CHF患儿和混合型CHF患儿脾肿大和肝硬化的发生率无显著差异。混合型CHF患儿的血浆凝血酶原活性、白细胞计数、血小板计数、平均血小板体积、血清丙氨酸转氨酶、天冬氨酸转氨酶、碱性磷酸酶、γ-谷氨酰转移酶、亮氨酸氨基肽酶和总胆汁酸水平高于PH CHF患儿(P<0.05)。混合型CHF患儿国际标准化比值降低和血清白蛋白水平降低的发生率高于PH CHF患儿(P<0.05)。
PH型和混合型CHF是儿童CHF的常见类型。这两种PH型患儿通常表现出门静脉高压,如肝硬化和肝脾肿大。混合型CHF患儿肝脏损害可能常见。