胆道闭锁婴儿的长期自体肝存活及粪便颜色卡的使用：病例对照研究
Long-term native liver survival in infants with biliary atresia and use of a stool color card: Case-control study.
作者信息
Gu Yan-Hong, Matsui Akira
机构信息
Department of Hygiene and Public Health, Osaka Medical College, Osaka, Japan.
Department of Hepatology, National Medical Center for Children and Mothers, National Center for Child Health and Development, Tokyo, Japan.
出版信息
Pediatr Int. 2017 Nov;59(11):1189-1193. doi: 10.1111/ped.13360. Epub 2017 Sep 29.
BACKGROUND
So far, there has been no epidemiological study on whether long-term native liver survival (NLS) in infants with biliary atresia (BA) is associated with use of a stool color card (SCC).
METHODS
A case-control study was performed, involving two associations for patients with BA in Japan. Participants were patients with BA who were born and underwent their first open Kasai procedures (KP) between August 1994 and March 2011, and who were also members of either of two associations for patients with BA in Japan. SCC users were classified as cases and SCC non-users as controls.
RESULTS
Mean age at the time of the first open KP was 59.7 and 68.2 days in SCC users and non-users, respectively (P < 0.05). According to Kaplan-Meier analysis, the probability of NLS at 12.5 years was 48.5% and 36.6% in SCC users and non-users (P < 0.05), respectively. On Cox proportional hazard modeling, not using an SCC was harmful to long-term NLS (hazard ratio, 2.61; 95% CI: 1.20-5.70; P = 0.016), adjusted for sex, age of timing of KP and type of BA.
CONCLUSIONS
Long-term NLS is associated with SCC for early detection, but not associated with age or a threshold of age at KP (<90 days) in patients with BA.
背景
迄今为止，尚无关于胆道闭锁（BA）患儿长期自体肝存活（NLS）是否与使用大便颜色卡（SCC）相关的流行病学研究。
方法
进行了一项病例对照研究，涉及日本的两个BA患者协会。参与者为1994年8月至2011年3月期间出生并接受首次开放性Kasai手术（KP），且为日本两个BA患者协会中任一协会成员的BA患者。使用SCC者被分类为病例组，未使用SCC者为对照组。
结果
首次开放性KP时，SCC使用者和非使用者的平均年龄分别为59.7天和68.2天（P<0.05）。根据Kaplan-Meier分析，12.5岁时SCC使用者和非使用者的NLS概率分别为48.5%和36.6%（P<0.05）。在Cox比例风险模型中，调整性别、KP时机年龄和BA类型后，未使用SCC对长期NLS有害（风险比，2.61；95%CI：1.20 - 5.70；P = 0.016）。
结论
长期NLS与用于早期检测的SCC相关，但与BA患者的年龄或KP时的年龄阈值（<90天）无关。
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