关键词: 肝内胆汁淤积症, 肝肋下肿大程度, 凝血功能, 血清白蛋白

Abstract: Objective:To analyze the correlation between serum albumin(ALB) and liver function and coagulation function in childrenwith intrahepatic cholestasis(NICCD).Methods:The clinical data of 56 children with NICCD treated in our hospital between March 2017 and March 2020 were retrospectively analyzed. Based on the level of serum ALB, these children weredivided into low-ALB group(ALB<30 g/L)(26 cases) and normal-ALB group (ALB≥30 g/L)(30 cases). Compare the differences in the degree of subcostal hepatomegaly and the coagulation indexes［(activatedpartial thromboplastin time(APTT), prothrombin time(PT), thrombin time(TT) and fibrinogen(FIB)］. Spearman correlation analysis method was used to analyze the correlation of the level of serum ALB with the degree of subcostal hepatomegaly and coagulation indexes in children with NICCD. Based on the prognosticliver function of NICCD children, they were divided into good-prognosis group (ALB=35-55 g/L, alanine transaminase≤40 U/L)(43 cases) and bad-prognosis group(ALB<35 g/L or ALB>55 g/L, alaninetransaminase>40 U/L)(13 cases). ROC was used to describe the efficiency of the degree of subcostal hepatomegaly and coagulation indexes in predicting the prognostic liver function of NICCD children.Results:The degree of subcostal hepatomegalyand the APTT level were significantly higher in low-ALB group than in normal-ALB group,while FIB level was significantly lower, and there was statistical difference (P<0.05); there was no statistical difference in the PT level or TT level between the two groups(P>0.05). Pearson correlation analysis showedthat the ALB level was negatively correlated with the degree of subcostal hepatomegaly and APTT level, andpositively correlated with FIB level (P<0.05), but not correlated with PT or TT level(P>0.05). The degree of subcostal hepatomegaly and APTT level were significantly lower in good-prognosis group than in bad-prognosis group, while FIB level was significantly higher(P<0.05), but there was no statistical difference in PT or TT level between the two groups(P>0.05). The cut-off value of the degree of subcostal hepatomegaly, APTT and FIB in predicting bad prognosis of NICCD children was 3.3 cm, 46.7 s and 1.4 g/L, respectively.Conclusion:The level of serum ALB is related to the degree of subcostal hepatomegaly and coagulation function inNICCD children, and the degree of subcostal hepatomegaly and the level of APTT and FIB of NICCD children are closely correlated with their prognostic liver function, so the detection of them can be used in the prevention and treatment of bad prognosis of liver function in neonates.

Key words: Intrahepatic cholestasis, Degree of subcostal hepatomegaly, Coagulation function, Serum albumin