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Objective To compare the curative effect of hepatocyte growth factor(HGF) in treatment of infant hepatitis syndrome (IHS) caused by cytomegalovirus with ganciclovir.Methods Sixty-eight cases with infant hepatitis syndrome caused by cytomegalovirus from neonatology department of our hospital from September 2010 to September 2014 were randomly divided into two groups, the observation group (32 cases)took HGF and ganciclovir therapy and the control group (36 cases) only received ganciclovir treatment Both groups were given conventional guard liver therapy.After one month of treatment, liver function, cytomegalovirus DNA content,extinction time of jaundice, treatment efficiency and the adverse reaction rate were evaluated for two groups.Results Liver function of children in observation group improved significantly after treatment compared with the control group, CMV-DNA quantitatively lower than the control group, the extinction time of jaundice was earlier than the latter,and the overall treatment efficiency was higher in observation group (P ＜0.05);The adverse reaction has no significant difference between two groups (P ＞ 0.05).Conclusion HGF combined with ganciclovir treatment can significantly improve liver function in patients of IHS caused by cytomegalovirus infection, and can collaboratively reduce viral load.Symptoms subside quickly with fewer adverse reactions, which is worthy of clinical promotion.
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Objective To retrospectively evaluate different methods (laboratory tests,liver / gallbladder ultrasound and magnetic resonance cholangiopancreatography)in differentiating biliary atresia from infant hepatitis syndrome.Methods Seventy infants with cholestatic jaundice,50 cases of biliary atresia and 20 cases of infant hepatitis syndrome were studied prospectively from January 2010 to December 2012.All cases underwent abdominal ultrasound and magnetic resonance cholangiopancreatography.The accuracy,sensitivity,specificity and predictive values of these various methods were compared.Also the laboratory parameters were statistically analyzed and compared between groups.Results Patients with BA had significantly higher GGT values at presentation [(743.5 ± 564) IU/L] compared with infants with IHS [(198.8 ± 197.8) IU/L],showing statistically significant difference (P ＜ 0.05).The sensitivity,specificity,and accuracy of the ultrasound in diagnosis of BA were 84.0％ 、100.0％ 、88.6％ respectively(P ＜ 0.05).The values for magnetic resonance cholangiopancreatography were 82.0％ 、80.0％ 、81.4％ (P ＜ 0.05).Conclusion Currently,the method of ultrasound is more reliable than MRCP for differentiating biliary atresia from infant hepatitis syndrome.
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Objective To evaluate the value of laparoscopic-assisted cholangiography in diagnosing prolonged jaundice in infants.Methods Through an umbilical troear,an laparoscope was placed into the abdominal cavity to detect the gallbladder and liver.After confirming that the choleeyst is normal,we pulled out the fundus of the gallbladder through the right subcostal trocar,and then inserted a catheter into the gallbladder for cholangiography.If the fundus could not be exteriorized because of gallbladder atresia, the patient would be converted to an open surgery.Results Cholangiography showed infant hepatitis syndrome or cholestasis in 8 cases,biliary hypoplasia in 2,and biliary atresia in 2.In 5 patients,the gallbladder was dissected from the liver bed before cholangiography,2 of them had biliary hypoplasia and 3 showed biliary atresia.Cholangiography was given up in 21 children because of liver cirrhosis.These patients were diagnosed with biliary atresia and then were treated by Kasai portoenterostomy. Conclusions Laparoscopic-assisted cholangiography is a simple,accurate,and safe method in the diagnosis of prolonged jaundice in infants.By using the procedure,the whole biliary tree can be shown clearly without leading to serious injuries.
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Objective To explore the clinical efficacy and side effect of hepatocyte growth - promoting factor in treatment of infant hepatitis syndrome. Methods Sixty one cases of infant hepatitis syndrome were chased as the treatment group who hospitalized in our hospital from March 2002 to Feb 2003,and 54 cases of infant hepatitis syndrome as control group who hospitalized during March 2001 to Feb 2002. The treatment group were administrated with hepatocyte growth - promoting factor for 2 weeks. We obser-ved the recovery of patient's liver function (TBIL.ALT, AST) and the side effect of hepatocyte growth- promoting factor after two weeks of the treatment. Results After the treatment,TBIL and ALT decreased significantly in the treatment group of infant hepatitis syndrome. The treatment group was superior to the control group (P