Dong Rui, Sun Song, Liu Xiao-Zhou, Shen Zhen, Chen Gong, Zheng Shan
Department of Pediatric Hepatobiliary Surgery, Children's Hospital of Fudan University and Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, China.
Gastroenterol Res Pract. 2017;2017:7496860. doi: 10.1155/2017/7496860. Epub 2017 Jun 11.
To analyze the levels of fat-soluble vitamins (FSVs) in pediatric patients with biliary atresia (BA) before and after the Kasai procedure.
Pediatric patients with obstructive jaundice were enrolled in this study. The FSV levels and liver function before, 2 weeks after, and 1, 3, and 6 months after the Kasai procedure were measured.
FSV deficiency was more obvious in patients with BA than in patients with other cholestatic liver diseases, especially vitamin D deficiency. 25-Hydroxy vitamin D (25-(OH)D) deficiency was more pronounced in younger patients before surgery. The 25-(OH)D level was significantly higher in patients with than without resolution of jaundice 3 months after surgery. At 6 months after surgery, the 25-(OH)D level was abnormally high at 8.76 ng/ml in patients with unresolved jaundice.
Preoperative FSV deficiency, particularly vitamin D deficiency, is common in patients with BA. 25-(OH)D deficiency is more pronounced in younger children before surgery. Postoperative FSV deficiency was still prevalent as shown by the lower 25-(OH)D levels in patients with BA and unresolved jaundice. This required long-term vitamin AD supplementation for pediatric patients with BA and unresolved jaundice after surgery.
分析 Kasai 手术后胆道闭锁（BA）患儿体内脂溶性维生素（FSV）的水平。
本研究纳入了患有阻塞性黄疸的患儿。测量了 Kasai 手术前、术后 2 周以及术后 1、3 和 6 个月时的 FSV 水平和肝功能。
BA 患儿的 FSV 缺乏比其他胆汁淤积性肝病患儿更为明显，尤其是维生素 D 缺乏。术前，年龄较小的患儿 25-羟基维生素 D（25-(OH)D）缺乏更为显著。术后 3 个月，黄疸消退的患儿 25-(OH)D 水平显著高于黄疸未消退的患儿。术后 6 个月，黄疸未消退患儿的 25-(OH)D 水平异常升高，为 8.76 ng/ml。
术前 FSV 缺乏，尤其是维生素 D 缺乏，在 BA 患儿中很常见。术前年龄较小的儿童 25-(OH)D 缺乏更为明显。术后 FSV 缺乏仍然普遍，BA 患儿且黄疸未消退者的 25-(OH)D 水平较低表明了这一点。这就需要对 BA 患儿且术后黄疸未消退者长期补充维生素 AD。
