Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Pediatr Surg Int. 2024 Aug 21;40(1):239. doi: 10.1007/s00383-024-05800-2.
Biliary atresia (BA) poses a persistent challenge characterized by ongoing liver inflammation and subsequent fibrosis even after the clearance of jaundice (COJ). This study aimed to evaluate the therapeutic potential of eicosapentaenoic acid (EPA) in alleviating liver inflammation and limiting fibrosis during the post-COJ phase of BA.
Among the BA patients undergoing laparoscopic Kasai portoenterostomy (lapKP) between December 2016 and October 2021, EPA (20-40 mg/kg/day) was administered orally to those whose parents consented. The study included patients from January 2014 to October 2021, classifying them into two groups: EPA-treated (Group E) and untreated (Group N). Their liver fibrosis and clinical course at 1 and 2 years post-lapKP were compared.
Group E consisted of 25 patients, while Group N comprised 32 patients. Twenty-one patients in Group E and 25 patients in Group N achieved COJ (p = 0.74). Among jaundice-free patients at 1 and 2 years post-lapKP, Group E exhibited significantly lower M2BPGi levels and platelet counts, and Group E showed a significant reduction in Aminotransferase-to-Platelet Ratio Index (APRI) at 2 years post-lapKP.
Although EPA administration did not improve COJ, it attenuated the progression of liver fibrosis during the 2 years following lapKP in jaundice-free patients. (200/200Words).
先天性胆道闭锁(BA)是一种持续存在的挑战,其特征是即使在黄疸消退(COJ)后仍存在持续的肝脏炎症和随后的纤维化。本研究旨在评估二十碳五烯酸(EPA)在缓解 BA 的 COJ 后阶段的肝脏炎症和限制纤维化方面的治疗潜力。
在 2016 年 12 月至 2021 年 10 月期间接受腹腔镜胆囊肠吻合术(lapKP)的 BA 患者中,对同意的患者口服给予 EPA(20-40mg/kg/天)。本研究纳入了 2014 年 1 月至 2021 年 10 月期间的患者,将其分为两组:EPA 治疗组(E 组)和未治疗组(N 组)。比较两组患者在 lapKP 后 1 年和 2 年的肝纤维化和临床病程。
E 组包括 25 例患者,N 组包括 32 例患者。E 组中有 21 例和 N 组中有 25 例患者达到 COJ(p=0.74)。在 lapKP 后 1 年和 2 年时黄疸消退的患者中,E 组的 M2BPGi 水平和血小板计数明显较低,E 组在 lapKP 后 2 年时的天门冬氨酸氨基转移酶与血小板比值指数(APRI)显著降低。
尽管 EPA 给药并未改善 COJ,但它在 lapKP 后 2 年内减轻了黄疸消退患者的肝纤维化进展。(200/200 字)。