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孟加拉国一家三级护理医院中巨细胞病毒免疫球蛋白M阳性和巨细胞病毒免疫球蛋白M阴性婴儿胆汁淤积症的比较研究。

A Comparative Study Between Cytomegalovirus Immunoglobulin M-Positive and CMV Immunoglobulin M-Negative Biliary Atresia in Infants Attending a Tertiary Care Hospital in Bangladesh.

作者信息

Akter Sharmin, Karim A S M Bazlul, Mazumder Md Wahiduzzaman, Rukunuzzaman Md, Nahid Khan Lamia, Dey Bishnu Pada, Sayeed Maimuna, Rahman A Z M Raihanur, Fathema Kaniz, Khadga Mukesh

机构信息

Department of Pediatric Gastroenterology & Nutrition, Faculty of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

Department of Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

出版信息

Pediatr Gastroenterol Hepatol Nutr. 2022 Sep;25(5):413-421. doi: 10.5223/pghn.2022.25.5.413. Epub 2022 Sep 5.

DOI:10.5223/pghn.2022.25.5.413
PMID:36148290
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9482831/
Abstract

PURPOSE

Perinatal cytomegalovirus (CMV) infection can lead to biliary atresia (BA) in different entities. This study aimed to compare the clinical, hematological, biochemical, and histological features of infants with BA based on their CMV immunoglobulin M (IgM) status at presentation.

METHODS

This cross-sectional descriptive study was carried out between January 2019 and June 2020 at the Department of Pediatric Gastroenterology and Nutrition at the Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka. Forty-three patients with BA were selected purposively and categorized into either the CMV IgM-positive or CMV IgM-negative BA group. Categorical variables were compared using Fisher's exact test and chi-square tests, while the Student's -test and Mann-Whitney U-test were used to compare continuous variables. For all statistical tests, a -value <0.05 was considered statistically significant.

RESULTS

Thirty-three (76.7%) of the cases were between 2 and 3 months of age on admission. The clinical, hematological, and biochemical parameters did not differ significantly between the CMV IgM-positive and CMV IgM-negative BA groups. Most (50.0%) of the CMV IgM-positive cases had fibrosis stage F2, while 43.5% of the CMV IgM-negative cases had fibrosis stage F3, with no significant difference between the groups (=0.391).

CONCLUSION

Our data shows no significant distinction between CMV IgM-positive and CMV IgM-negative BA, suggesting that CMV does not contribute to BA pathogenesis.

摘要

目的

围产期巨细胞病毒(CMV)感染可导致不同类型的胆道闭锁(BA)。本研究旨在比较初诊时基于CMV免疫球蛋白M(IgM)状态的BA婴儿的临床、血液学、生化和组织学特征。

方法

本横断面描述性研究于2019年1月至2020年6月在达卡的孟加拉国谢赫穆吉布医学大学(BSMMU)儿科胃肠病学和营养科进行。有目的地选择了43例BA患者,并将其分为CMV IgM阳性或CMV IgM阴性BA组。分类变量采用Fisher精确检验和卡方检验进行比较,连续变量采用学生t检验和Mann-Whitney U检验进行比较。对于所有统计检验,P值<0.05被认为具有统计学意义。

结果

33例(76.7%)病例入院时年龄在2至3个月之间。CMV IgM阳性和CMV IgM阴性BA组之间的临床、血液学和生化参数无显著差异。大多数(50.0%)CMV IgM阳性病例的纤维化分期为F2,而43.5%的CMV IgM阴性病例的纤维化分期为F3,两组之间无显著差异(P=0.391)。

结论

我们的数据显示CMV IgM阳性和CMV IgM阴性BA之间无显著差异,表明CMV对BA发病机制无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/168e/9482831/eae9493bf47f/pghn-25-413-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/168e/9482831/eae9493bf47f/pghn-25-413-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/168e/9482831/eae9493bf47f/pghn-25-413-g001.jpg

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本文引用的文献

1
Biliary Atresia: Clinical and Research Challenges for the Twenty-First Century.先天性胆道闭锁:二十一世纪的临床与研究挑战。
Hepatology. 2018 Sep;68(3):1163-1173. doi: 10.1002/hep.29905.
2
Cytomegalovirus-associated biliary atresia: An aetiological and prognostic subgroup.巨细胞病毒相关性胆道闭锁:一个病因学和预后亚组。
J Pediatr Surg. 2015 Oct;50(10):1739-45. doi: 10.1016/j.jpedsurg.2015.03.001. Epub 2015 Mar 7.
3
Problems related to CMV infection and biliary atresia.与巨细胞病毒感染和胆道闭锁相关的问题。
S Afr Med J. 2012 Sep 11;102(11 Pt 2):890-2. doi: 10.7196/samj.6163.
4
The perinatal infection of cytomegalovirus is an important etiology for biliary atresia in China.在中国,巨细胞病毒的围产期感染是导致胆道闭锁的一个重要病因。
Clin Pediatr (Phila). 2012 Feb;51(2):109-13. doi: 10.1177/0009922811406264. Epub 2011 Dec 5.
5
Is there any association of extra hepatic biliary atresia with cytomegalovirus or other infections?肝外胆道闭锁与巨细胞病毒或其他感染之间是否存在关联?
J Pak Med Assoc. 2011 Mar;61(3):281-3.
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Study of viral infections in infants with biliary atresia.婴儿胆道闭锁的病毒感染研究。
Indian J Pediatr. 2011 Apr;78(4):478-81. doi: 10.1007/s12098-010-0309-5. Epub 2010 Dec 17.
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Biliary atresia.胆道闭锁
Lancet. 2009 Nov 14;374(9702):1704-13. doi: 10.1016/S0140-6736(09)60946-6.
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Impact of human cytomegalovirus infection UL55-nested polymerase chain reaction method in hematopoietic stem cell transplant donors and recipients.人巨细胞病毒感染UL55巢式聚合酶链反应方法在造血干细胞移植供者和受者中的影响
Transplant Proc. 2009 Sep;41(7):2898-9. doi: 10.1016/j.transproceed.2009.07.042.
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Early cytomegalovirus infection and the long-term outcome of biliary atresia.早期巨细胞病毒感染与胆道闭锁的长期预后
Acta Paediatr. 2009 Oct;98(10):1600-2. doi: 10.1111/j.1651-2227.2009.01416.x. Epub 2009 Jul 9.
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Cholangiocytes as immune modulators in rotavirus-induced murine biliary atresia.胆管细胞在轮状病毒诱导的小鼠胆道闭锁中作为免疫调节因子
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