目的 探讨α1-抗胰蛋白酶缺乏症合并胆道闭锁的临床特点及早期诊断。方法 回顾性分析1例α1-抗胰蛋 白酶缺乏症合并胆道闭锁患儿的临床资料，并复习国内外相关文献。结果 患儿，男，新生儿期即出现黄疸、肝脏肿大，血 清谷丙转氨酶及谷草转氨酶升高、总胆红素和直接胆红素升高、 γ-谷氨酰转肽酶增高，行十二指肠引流未引流出胆汁，手 术探查、术中胆道造影及术后病理证实为胆道闭锁。基因检测发现SERPINA1突变，明确诊断为α1-抗胰蛋白酶缺乏症合 并胆道闭锁。复习国内外文献， α1-抗胰蛋白酶缺乏性肝病患儿主要表现为胆汁淤积性黄疸、肝脾肿大、低白蛋白血症、血 清谷丙转氨酶及谷草转氨酶升高、维生素K缺乏或肝脏合成功能障碍导致的凝血异常疾病；若早期不能及时诊断及进行 干预治疗可引起进行性肝病或肝硬化。结论 对不明原因胆汁淤积性肝病的患儿应积极寻找病因，必要时行基因检测，及 早诊断、治疗，改善预后。

Objectives  To study the clinical characteristics and early diagnosis of infant with both alpha 1 antitrypin  deficiency (α1-ATD) and biliary atresia (BA). Methods The clinical characteristics, serum biochemical parameters, gene  mutations and treatment of one infant with both α1-ATD and BA was reported. Related literatures about liver disease caused by  α1-ATD were reviewed and analyzed. Results The infant was characterised with neonatal cholestasis, hepatomegaly, elevated  serum ALT, AST, total bilirubin (TB), direct bilirubin (DB) and γ-glutamyltransferase (γ-GT) and absence of bile secretion  from the duodenal drainage tube. BA was confirmed by laparotomy and pathological examination and Kasai′s operation was  performed. Further, the infant was confirmed by SERPINA1 gene mutation analysis, which leads to the diagnosis of α1-ATD. The  case of infant with both alpha 1 ATD and BA has not yet been reported at home and abroad. According to the literatures, children  with α1-ATD were characterized with cholestasis, hepatomegaly, hypoproteinemia, high serum ALT and AST, coagulation  disorders caused by vitamin K1 deficiency and hepatic dysfunction. Prognosis was poor without early diagnosis and treatment.  Conclusions For infant cholestasis, a lot of auxiliary examinations should be performed to identify the etiology of cholestasis.  Gene analysis could help differential diagnosis. Prompt diagnosis and early treatment are the key to improve the survival rate and  prognosis.