Tyler K L, Sokol R J, Oberhaus S M, Le M, Karrer F M, Narkewicz M R, Tyson R W, Murphy J R, Low R, Brown W R
Department of Neurology, University of Colorado Health Sciences Center, Denver 80262, USA.
Hepatology. 1998 Jun;27(6):1475-82. doi: 10.1002/hep.510270603.
Extrahepatic biliary atresia (EHBA) and choledochal cysts (CDC) are important causes of obstructive jaundice in pediatric patients. Viruses in general, and reoviruses in particular, have long been considered as possible etiologic agents responsible for inciting the inflammatory process that leads to these infantile obstructive cholangiopathies. In an effort to determine whether reovirus infection is associated with these disorders, we used a sensitive and specific reverse-transcriptase polymerase chain reaction (RT-PCR) technique designed to amplify a portion of the reovirus L1 gene segment from extracts of liver and/or biliary tissues. These tissues were obtained at the time of liver biopsy or surgical procedures from 23 patients with EHBA, 9 patients with CDC, and 33 patients with other hepatobiliary diseases. Hepatic and biliary tissues obtained at autopsy from 17 patients who died without known liver or biliary disease were also analyzed. Reovirus RNA was detected in hepatic and/or biliary tissues from 55% of patients with EHBA and 78% of patients with CDC. Reovirus RNA was found also in extracts of hepatic and/or biliary tissue from 21% of patients with other hepatobiliary diseases and in 12% of autopsy cases. The prevalence of reovirus RNA in tissues from patients with EHBA and CDC was significantly greater than that in patients with other hepatobiliary diseases (chi2 P = .012 EHBA vs. OTHER, P = .001 CDC vs. OTHER), or AUTOPSY cases (chi2 P = .006 EHBA vs. AUTOPSY, P < .001 CDC vs. AUTOPSY).
肝外胆道闭锁（EHBA）和胆总管囊肿（CDC）是小儿患者梗阻性黄疸的重要病因。一般而言，病毒，尤其是呼肠孤病毒，长期以来一直被认为是引发导致这些婴儿梗阻性胆管病的炎症过程的可能病原体。为了确定呼肠孤病毒感染是否与这些疾病有关，我们使用了一种灵敏且特异的逆转录酶聚合酶链反应（RT-PCR）技术，旨在从肝脏和/或胆道组织提取物中扩增呼肠孤病毒L1基因片段的一部分。这些组织是在肝活检或手术时从23例EHBA患者、9例CDC患者以及33例其他肝胆疾病患者中获取的。还分析了17例死因不明的肝脏或胆道疾病患者尸检时获得的肝脏和胆道组织。在55%的EHBA患者和78%的CDC患者的肝脏和/或胆道组织中检测到了呼肠孤病毒RNA。在21%的其他肝胆疾病患者的肝脏和/或胆道组织提取物以及12%的尸检病例中也发现了呼肠孤病毒RNA。EHBA和CDC患者组织中呼肠孤病毒RNA的患病率显著高于其他肝胆疾病患者（卡方检验，EHBA与OTHER相比P = 0.012，CDC与OTHER相比P = 0.001），或尸检病例（卡方检验，EHBA与AUTOPSY相比P = 0.006，CDC与AUTOPSY相比P < 0.001）。
