Mashhadi Amin, Khalili Manijeh, Moghaddam Alireza Ansari, Zadehmir Mohadeseh
Department of Radiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
Children and Adolescent Health Research Center, Resistant Tuberculosis Institute, Zahedan University Medical Sciences, Zahedan, Iran.
J Med Ultrasound. 2022 Sep 22;30(4):272-276. doi: 10.4103/jmu.jmu_196_21. eCollection 2022 Oct-Dec.
The present study aimed to investigate the prognostic value of porta-hepatis lymphadenopathy (PHL) in children with hepatitis A virus.
The present prospective cohort study included 123 pediatric patients with a definite diagnosis of hepatitis A who were divided into two groups based on the presence or absence of PHL in their abdominal ultrasound: Group A included the patients with a porta-hepatis lymph node of >6 mm in diameter, whereas the patients with a porta-hepatis lymph node of <6 mm in diameter were classified in Group B. The patients were also classified based on the presence or absence of para-aortic lymphadenopathy: Group C had bisecting para-aortic lymph nodes, whereas Group D did not have such findings in their ultrasound. Afterward, the groups were compared in laboratory investigation results and hospital stay.
According to our results, Group A ( = 57) was significantly higher in aspartate and alanine aminotransferase and alkaline phosphatase levels compared to Group B ( < 0.05), whereas these two groups were not significantly different in the hospital stay. Furthermore, except bilirubin, all laboratory test results were significantly higher in Group C ( = 3) than in Group D. However, there was no significant correlation between the patients' prognosis with the absence or presence of porta-hepatis or para-aortic lymphadenopathy.
We concluded that there was no significant relationship between porta-hepatis or para-aortic lymphadenopathy and the prognosis of the children with hepatitis A. However, ultrasound findings can help determine the disease severity in pediatric patients with hepatitis A.
本研究旨在探讨肝门淋巴结肿大在甲型肝炎病毒感染儿童中的预后价值。
本前瞻性队列研究纳入了123例确诊为甲型肝炎的儿科患者，根据腹部超声检查结果有无肝门淋巴结肿大将其分为两组：A组为肝门淋巴结直径>6 mm的患者，而肝门淋巴结直径<6 mm的患者归入B组。患者还根据有无腹主动脉旁淋巴结肿大进行分类：C组有腹主动脉旁淋巴结肿大，而D组在超声检查中未发现此类情况。之后，对各组的实验室检查结果和住院时间进行比较。
根据我们的结果，A组（n = 57）的天冬氨酸转氨酶、丙氨酸转氨酶和碱性磷酸酶水平显著高于B组（P < 0.05），而这两组的住院时间无显著差异。此外，除胆红素外，C组（n = 3）的所有实验室检查结果均显著高于D组。然而，患者的预后与有无肝门或腹主动脉旁淋巴结肿大之间无显著相关性。
我们得出结论，肝门或腹主动脉旁淋巴结肿大与甲型肝炎儿童的预后之间无显著关系。然而，超声检查结果有助于确定甲型肝炎儿科患者的疾病严重程度。
