γ-谷氨酰转肽酶联合直接胆红素在不同年龄段儿童对胆道闭锁的诊断价值

doi:10.20274/j.cnki.issn.1674-3865.2025.03.008

Abstract

Abstract:

Objective To explore the diagnostic value of gamma glutamyltranspeptidase (GGT) combined with direct bilirubin (DBIL) for biliary atresia in different age groups. Methods A total of 71 children with non?biliary atresia cholestasis and 130 children with biliary atresia who visited Zhengzhou University Children's Hospital from June 2019 to December 2022 were selected as the study subjects. Compare the gender composition of two groups of children and the differences in GGT, alkaline phosphatase (ALP), DBIL, alanine aminotransferase (ALT), and total bile acid (TBA) between two groups of children at different ages.Draw receiver operating characteristic curves (ROC) for the indicators with differences, and compare the diagnostic value of each indicator for biliary atresia. Results (1) The incidence rate in girls with biliary atresia at different ages was higher than that in girls without biliary atresia (P<0.05). (2) Among children aged 30–60 days, the GGT and DBIL levels in the biliary atresia group were higher than those in the non?biliary atresia group, and the difference was statistically significant (P<0.05). The differences in other indicators were not statistically significant (P>0.05). The area under the curve (AUC) values of GGT, DBIL, and GGT combined DBIL for biliary atresia were 0.874, 0.903, and 0.927, respectively.When GGT >175.4 U/L was selected, the sensitivity and specificity for biliary atresia were 0.791 and 0.844 respectively.When DBIL >79.0 μmol/L was selected, the sensitivity and specificity for biliary atresia were 0.837 and 0.844 respectively. (3) Among children aged >60–90 days, the GGT, DBIL, and TBA levels in the biliary atresia group were higher than those in the non?biliary atresia group, and the difference was statistically significant (P<0.05).The differences in other indicators were not statistically significant (P>0.05). The AUC values of GGT, DBIL and GGT combined DBIL for biliary atresia were 0.910, 0.944 and 0.962,respectively.When GGT >170.4 U/L was selected, the sensitivity and specificity for biliary atresia were 0.909 and 0.821, respectively.When DBIL >74.9 μmol/L was selected, the sensitivity and specificity for biliary atresia were 0.932 and 0.846, respectively. Conclusion (1) For children aged 30–60 days and >60–90 days, GGT and DBIL have high diagnostic efficacy for biliary atresia, and the combined diagnostic efficacy of them is even better. (2) For children aged 30–60 days, GGT and DBIL have shown high sensitivity and specificity for biliary atresia. Therefore, early detection of liver function is crucial to reducing missed diagnosis of biliary atresia.

Key words: Cholestasis, Biliary atresia, Early diagnosis, Child

CLC Number:

R657.4+4

Lijuan ZHENG, Fumin XUE, Jing YU. Diagnostic value of GGT combined with DBIL for biliary atresia in different age groups of children[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(3): 231-236.

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References 23

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组别	30～60 d			>60～90 d
组别	n	男	女	n	男	女
非胆道闭锁组	32	25（78.1）	7（21.9）	39	27（69.2）	12（30.8）
胆道闭锁组	86	45（52.3）	41（47.7）^a	44	19（43.2）	25（56.8）^a

组别	n	30～60 d
组别	n	GGT（U/L）	ALP（U/L）	DBIL(μmol/L)	ALT(U/L)	TBA(μmol/L)
非胆道闭锁组	71	102.4(72.4,160.8)	574.6(388.9,650.4)	44.4(31.5,75.9)	107.9(60.7,165.8)	95.2(62.5,127.0)
胆道闭锁组	130	278.9(190.7,429.6)	490.1(345.6,582.6)	106.2(86.3,137.8)	95.6(59.7,137.2)	108.8(83.7,134.1)
Z值		-6.235	-1.471	-6.713	-0.478	-1.656
P值		<0.001	0.141	<0.001	0.632	0.098
组别	n	>60～90 d
组别	n	GGT（U/L）	ALP（U/L）	DBIL(μmol/L)	ALT(U/L)	TBA(μmol/L)
非胆道闭锁组	71	98.8(75.0,162.0)	509.9(421.2,651.2)	46.2(30.0,68.5)	133.9(75.2,206.9)	108.0(71.8,130.9)
胆道闭锁组	130	309.1(211.4,681.9)	570.7(451.5,685.1)	109.4(90.5,136.3)	141.5(84.0,246.0)	136.4(106.0,157.2)
Z值		-6.423	-1.077	-6.957	-0.091	-3.157
P值		<0.001	0.282	<0.001	0.927	0.002

指标	AUC	95%CI	临界值	敏感度	特异度	约登指数
GGT	0.910	0.847～0.973	170.4	0.909	0.821	0.73
DBIL	0.944	0.894～0.995	74.9	0.932	0.846	0.778
TBA	0.702	0.589～0.814	140.1	0.477	0.897	0.374
GGT+DBIL	0.962	0.919～1.000	-	-	-	-

Diagnostic value of GGT combined with DBIL for biliary atresia in different age groups of children

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指标	AUC	95%CI	临界值	敏感度	特异度	约登指数
GGT	0.874	0.801～0.947	175.4	0.791	0.844	0.635
DBIL	0.903	0.831～0.975	79.0	0.837	0.844	0.681
GGT+DBIL	0.927	0.870～0.983	-	-	-	-

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