| Purpose:biliary atresia (Biliary atresia, BA) is the most common causes of neonatal obstructive jaundice.Portal jejunum anastomosis (Kasai operation) is the treatment of first choice, but the overall results of operations is poor, particularly poor long-term effects, most patients eventually require liver transplantation due to cirrhosis of the liver. The prognosis of biliary atresia patients is affected by many factors, such as the Kasai surgery patients to the age, the type of lesion, the severity of liver fibrosis and post-operative complications. Liver progressive fibrosis in biliary atresia is an important pathological feature of biliary atresia after biliary drainage poor, or the poor prognosis of the main reasons. Because older children, often the extent of liver fibrosis has been very serious.In the process of liver fibrosis,matrix metalloproteinase-2 (MMP-2)plays an important role.In this study, MMP-2 extracellular matrix metabolism-related factors were analyzed to understand the MMP-2 and liver fibrosis, while the MMP-2 and the degree of liver fibrosis, its likely prognosis.Therefore, determination of MMP-2 may reflect the prognosis of biliary atresia have the great meaning. Methods:First Affiliated Hospital of Guangxi Medical University Pediatric Surgery from January 2005 to January 2009 Kasai surgical resection of the liver specimens of 39 cases were based on age, sex, liver fibrosis, pathological type, one-year survival rate of target groups, using determined by immunohistochemistry biliary atresia and normal liver tissue, liver tissue expression of MMP-2,by the degree of hepatic fibrosis in children with surgery, combined with the clinical prognosis of the experimental data were statistically analyzed to determine MMP-2 and hepatic fibrosis in as well as the prognosis.Results:1 39 examples attain the revisit.The closure makes a follow-up visit the conclusion to survive 25 examples,2 years survival rate is 69.3%, the position life is 29.12 months.After technique shortest life 2 months, longest life 48 months.2 Cox model statistical analysis the technique the cholangitis outbreak situation, the surgery date and time age, the MMP-2 factor intensity, the liver fibrosis degree carries on as the variable the analysis, finally demonstrated, when MMP-2 factor intensity as well as surgery age for influence factor.(P=0.01 P＜0.05)3 MMP-2 is lower than the expression in the liver fibrosis degree light group's expression which reorganizes in the liver fibrosis degree, (P <0.05) the Z=-5.097 difference has statistics significance. Indicated biliary duct block system patient MMP-2 and the liver fibrosis degree concerns. 4 presses the MMP-2 factor intensity for the negative,the weak masculine gender, masculine and the strong masculine grouping, carries on the Kaplan-meier survival analysis,finally demonstrated, the MMP-2 factor negative group and the weak masculine group 2 years survival rate is highest, is (P<0.05),the masculine group survival rate is 61.33%(P<0.05)strong masculine group survival rate is 0%.5 presses the liver fibrosis degree light group and the liver fibrosis degree reorganizes the grouping, carries on the Kaplan-meier survival analysis, finally demonstrated, the liver fibrosis degree light group 2 years survival rate is high, is 96.13%,the liver fibrosis degree reorganizes the survival rate is 58.33%(P<0.05).Conclusion:The(1)MMP-2 expression intensity high expression prompt liver fibrosis is heavy for biliary duct block system trouble son Kasai the surgery prognosis influence factor (2)MMP-2, the low expression prompts the liver fibrosis to be light. liver fibrosis degree and the biliary duct block system prognosis have the relevance.After the... |
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