期刊
HEPATOLOGY
卷 46, 期 5, 页码 1632-1638出版社
JOHN WILEY & SONS INC
DOI: 10.1002/hep.21923
关键词
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资金
- NIDDK NIH HHS [U01DK062453, U01 DK062436, U01 DK062452, U01DK062481, U01DK062436, U01 DK062470-02, UO1DK062470, U01 DK062456, U01 DK062445, U01DK062497, U01DK062445, U01DK062456, U01DK062452, U01 DK062481, U01DK062500, U01 DK062470, U01DK062503, U01 DK062453, U01 DK062503, U01 DK062500, U01 DK062497] Funding Source: Medline
Malnutrition is a significant clinical problem in infants with biliary atresia. The natural history of poor growth and its potential association with early transplantation or death in children with biliary atresia was determined. Serial weight- and length-for-age z-scores were computed as part of a retrospective study of 100 infants who underwent hepatoportoenterostomy (HPE) for biliary atresia at 9 U.S. pediatric centers between 1997 and 2000. Poor outcome was defined as transplantation or death by 24 months of age (n = 46) and good outcome was defined as survival with native liver at 24 months ofage with total serum bilirubin less dun 6 mg/dL (n = 54). Growth velocity was significantly slower in the poor outcome group compared to the good outcome group (P < 0.001 for both weight and length). Mean weight z-scores were significantly lower by 6 months after HPE in the poor outcome group (-2.1 +/- 1.4) compared to the good outcome group (- 1.2 +/- 1.4) (P < 0.001). In a subgroup with total bilirubin between 2 and 6 mg/dL at 3 months after HPE (n = 28), the weight z-scores at 3 months after HPE were significantly lower in the poor outcome group (-2.0 +/- 1.2) compared to the good outcome group (- 1.0 +/- 1.2) (P = 0.04) despite similar bilirubin concentrations. Conclusiom Growth failure after HPE was associated with transplantation or death by 24 months of age. The combination of intermediate bilirubin concentrations and poor mean weight z-scores 3 months after HPE was also associated with poor clinical outcome.
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