临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (1): 6-.doi: 10.3969/j.issn.1000-3606.2021.01.002

• 营养及消化系统疾病专栏 • 上一篇    下一篇

330例遗传代谢性肝病患儿病因学分析

姜涛, 李双杰, 欧阳文献, 谭艳芳, 唐莲, 张慧   

  1. 湖南省儿童医院肝病中心科(湖南长沙 410007)
  • 出版日期:2021-01-15 发布日期:2021-01-15
  • 通讯作者: 李双杰 电子信箱:lesjie 62 @vip.sina.com

Etiological analysis of inherited metabolic liver disease in 330 children

JIANG Tao, LI Shuangjie, OUYANG Wenxian, TAN Yanfang, TANG Lian, ZHANG Hui   

  1. Department of Hepatopathy Center, Hunan Children's Hospital, Changsha 410007 , Hunan, China
  • Published:2021-01-15 Online:2021-01-15

摘要: 目的 分析遗传代谢性肝病的病因。方法 回顾分析2013年1月至2019年12月收治的遗传代谢性肝病患儿 的临床资料。结果 共330例遗传代谢性肝病患儿,男性205例、女性125例,发病年龄1月龄~14岁。病因有50余种类型, 依次为Citrin缺陷病(120例,36 . 36 %)、肝豆状核变性(WD,53例,16 . 06 %)、糖原累积症(GSD,52例,15 . 76 %)、遗传性 高胆红素血症(25例,7 . 58 %)、Alagille综合征(16例,4 . 85 %)和进行性家族性肝内胆汁淤积症(PFIC,10例,3 . 03 %)等。 患儿以胆汁淤积、氨基转移酶升高为主要首发表现,其中胆汁淤积188例(56 . 97 %)、氨基转移酶升高127例(38 . 48 %)。1 岁内发病者181例(54.85%),以Citrin缺陷症(120例)、GSD(10例)、PFIC(7例)、Alagille综合征(7例)和Dubin-Johnson 综合征(6例)为主;1岁及以上发病149例(45.15%),以GSD(42例)和WD(52例)为主。结论 遗传代谢性肝病病因复杂, 临床上应结合发病年龄和临床表现进行诊断分析。

关键词: 遗传代谢性肝病; 病因; 临床表现; 儿童

Abstract: Objective To explore the etiology of inherited metabolic liver disease. Method The clinical data of inherited metabolic liver disease in children admitted from January 2013 to December 2019 were retrospectively analyzed. Results A total of 330 (205 males and 125 females) children with inherited metabolic liver disease were enrolled and the onset age ranged from 1 month to 14 years. The etiology of the disease includes more than 50 causes, ordered from Citrin deficiency disease ( 120 cases, 36. 36%), Wilson disease (WD, 53 cases, 16. 06%), glycogen storage disease (GSD, 52 cases, 15. 76%), hereditary hyperbilirubinemia ( 25 cases, 7 . 58 %), Alagille syndrome ( 16 cases, 4 . 85 %) and progressive familial intrahepatic cholestasis (PFIC, 10 cases, 3. 03%), etc. Cholestasis and elevated transaminase were the main initial manifestations in the children, including 188 cases of cholestasis (56.97%) and 127 cases of elevated transaminase (38.48%). There were 181 children (54.85%) with onset age of less than 1 year and they mainly had Citrin deficiency disease ( 120 cases), glycogen storage disease ( 10 cases), PFIC (7 cases), Alagille syndrome (7 cases) and Dubin-Johnson syndrome (6 cases). There were 149 cases (45.15%) with onset age of 1 year or above, in which there were 42 cases of GSD and 52 cases of WD. Conclusion The etiology of inherited metabolic liver disease is complex, and the age at onset and clinical manifestations should be combined for clinical diagnosis and analysis.

Key words: inherited metabolic liver disease; etiology; clinical manifestation; child