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[婴儿直接胆红素血症鉴别诊断与治疗中LP-X的定量测定]

[Quantitative determination of LP-X in the differential diagnosis and treatment of direct hyperbilirubinemia in infancy].

作者信息

Deutsch J, Kurz R, Müller W D, Becker H

机构信息

Univ.-Kinderklinik Graz.

出版信息

Z Kinderchir. 1987 Aug;42(4):230-4. doi: 10.1055/s-2008-1075591.

Abstract

Quantitative measurements of serum concentrations of LP-X were performed in 45 newborn and infants. The changes of LP-X concentrations before and after a 2-3 weeks' course of cholestyramine therapy differentiated extrahepatic biliary atresia (n = 6) from other causes of neonatal liver disease with a sensitivity of 100%, a specificity of 78.6 to 84.6% and an efficiency of 81.3 to 86.7%. The efficiency was decreased in children with alcoholic stools (75-80%). Cholestyramine treatment of 3-7 days did not allow to diagnose all children with extrahepatic biliary atresia. However, the test was superior to a combination of single measurements of LP-X and GGT. The changes of LP-X concentrations in serum were influenced by the individual course of the disease but not by the synthetic function of the liver (as indicated by CHE activities) or by parenteral nutrition or bacterial infections. LP-X was a valuable parameter in the management of cholestyramine therapy in infants with liver diseases.

摘要

对45名新生儿和婴儿进行了血清LP-X浓度的定量测量。在接受2至3周消胆胺治疗前后,LP-X浓度的变化可将肝外胆道闭锁(n = 6)与新生儿肝病的其他病因区分开来,其敏感性为100%,特异性为78.6%至84.6%,有效率为81.3%至86.7%。在有酒精样粪便的儿童中,有效率有所下降(75%至80%)。3至7天的消胆胺治疗无法诊断出所有肝外胆道闭锁的儿童。然而,该检测优于LP-X和γ-谷氨酰转移酶(GGT)单项测量的联合检测。血清中LP-X浓度的变化受疾病个体进程的影响,但不受肝脏合成功能(以胆碱酯酶(CHE)活性表示)、肠外营养或细菌感染的影响。LP-X是肝病婴儿消胆胺治疗管理中的一个有价值的参数。

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