The Journal of Practical Medicine ›› 2021, Vol. 37 ›› Issue (12): 1607-1612.doi: 10.3969/j.issn.1006⁃5725.2021.12.019

• Medical Examination and Clinical Diagnosis • Previous Articles     Next Articles

Value of liver function index in the diagnosis of biliary atresia in infants 

YIN Runkai，ZHAO Ruiqin，FU Haiyan，BAI Gelan，LI Haihua，YIN Chunlan，SHI Weina，LIU Yali，CHENG Lijuan，JIA Xiaoyun，LI Guigui， ZHAO Shiguang，LI Xiaolei.    

  1. Department of Digestive Diseases，Hebei Children′ s Hospital，Shijiazhuang 050031， China 

  • Online:2021-06-25 Published:2021-06-25
  • Contact: ZHAO Ruiqin E⁃mail：runkaiy0311@sina.com

Abstract:

Objective To investigate the value of serum γ⁃glutamyl transpeptidase（GGT），direct biliru⁃ bin（DB），total bile acid（TBA）and alanine amino transferase（ALT）in the diagnosis of biliary atresia（BA）. Methods A total of 544 infants with cholestasis who were hospitalized and received treatment from January 2013 to January 2020 were enrolled in this study. According to the results of intraoperative cholangiography，they were divided into BA group with 268 infants and non⁃BA cholestasis group with 276 infants. Serum levels of GGT，DB， TBA and ALT were compared between the two groups. According to the age，infants were divided into 1 ~ 2 month group，2 ~ 3 month group and over 3 month group，and the four indexes were also analyzed among 3 group. A receiver operating characteristic（ROC）curve analysis was performed for indexes with statistical significance，and the area under the ROC curve（AUC）and the optimal cut ⁃off value for diagnosis were calculated. Results The BA group had a younger age of onset than that in the non⁃BA cholestasis group（P＜0.05）. There was no signifi⁃ cant difference in sex between the two groups，while the BA group had significantly higher serum levels of GGT， DB，TBA and ALT than those in the non⁃BA cholestasis group（P＜0.001）. GGT had the highest AUC of 0.828 （95% CI：0.794 ~ 0.863）in the diagnosis of BA，and at the optimal cut⁃off value of 276U/L it had a sensitivity of 70.8% and a specificity of 80.1%. GGT also had the highest AUC in the 1 ~ 2 month group（AUC = 0.857，95% CI： 0.804 ~ 0.910）and 2 ~ 3 month group（AUC = 0.883，95% CI：0.828 ~ 0.939）with the cut⁃off values of 194 U/L， 340 U/L. DB had the highest AUC of 0.758（95% CI：0.674 ~ 0.841）in the over 3 month group，and at the opti⁃ mal cut⁃off value of 112.45 μmmol/L，it had a sensitivity of 81.3% and a specificity of 64.8%. Conclusions Both GGT and DB had good diagnostic value for BA. GGT had good diagnostic value for children aged 1~3⁃month partic⁃ ularly，while DB had better diagnostic value for children aged over 3 months. 

Key words:

biliary atresia, γ?glutamyl transpeptidase, direct bilirubin, total bile acid, alanine amino transferase