| ObjectiveIt is to provide theoretical basis for clinical diagnosis and treatment of liverdysfunction in children by discussing575cases of liver dysfunction etiology andclinical characteristics of children.MethodsThe hospitalized children with liver dysfunction aged1month to14years oldwere selected as research subjects in Changchun Children’s Hospital from August2010to December2013. Samples of blood,urine, feces and throat secretion ofchildren was collected to use fluorescence quantitative (PCR) method to detectpathogens. It included the blood samples to check Toxoplasma gondii DNA,the urinesamples to check cytomegalovirus DNA, the throat secretions to check EB virus DNA,herpes simplex virus DNA, respiratory syncytial virus DNA and mycoplasmaDNA,and the stool specimens to check rotavirus DNA, enterovirus DNA. In addition,blood samples were collected to check hepatitis B, hepatitis A and hepatitis C by usingELISA, blood culture, conventional coagulation and blood genetic metabolicscreening examination.The data was statistically analysed using Chi-Square Test.Results1.There were575children complicated with liver dysfunction,including345boys and230girls. In this study，the children was divided into infants group, youngchildren group, preschool children group,and school children group. The number ofeach group was304cases (52.9%),139cases (24.2%),71cases (12.3%), and61cases(10.6%). The number of infants group and young children group was over than that ofothers.2.78.6%(452/575) cases had infectious disease,4.3%cases had noinfectious disease,17.0%(98/575) cases had infant hepatitis syndrome in575 cases.There were189cases (89.2%) with infectious disease,13cases(6.1%) withbacterial infection,8cases (3.8%) with mycoplasma infection,and1case (0.5%) withtoxoplasma infection in452cases of children with infectious disease.There were94cases (49.7%) with cytomegalovirus infection,58cases (30.7%) with epstein-barrvirus infection,6cases(3.2%) with intestinal universal virus,2cases (1.1%) withherpes simplex virus infection,15cases (7.9%) with rotavirus virus infection,8cases(4.2%) with EV71infection,3cases (1.6%) with CoxA16virus infection,3cases(1.6%) with respiratory syncytial virus infection In189cases with liver dysfunctioninfected by virus. There were7cases (1.2%) with drug-induced liver dysfunction,3cases(0.5%) with genetic metabolic diseases,4cases (0.7%) with congenital biliaryatresia in non-infectious disease.3. There were no clinical symptoms in most childrenwith liver dysfunction, There were38cases(6.6%) with jaudice,11cases(1.9%) withliver enlargement and4cases(0.7%) with spleen enlargement in severe cases.4. Mostchildren with infection of Cytomegalovirus are infants, and most children withinfection of epstein-barr virus are older children（χ2=27.51, P <0.05）.5. We dividedALT into three different levels:40<ALT<200U/L,200<ALT <400U/L,ALT>400U/L,the corresponding proportion was340cases (59.1%),204cases(35.5%),and31cases (5.4%).5. There were53.6%cases cured,34.4%casesimproved,10.8%cases increased,and mortality of1.2%cases during this research.1.6%cases led to liver failure,and the mortality of liver failure was44.4%.Conclusion1. The number of infants group and young children group was over than that ofothers. Infectious diseases is the main cause of liver dysfunction in children,in whichthe virus infection is most common cause of it, cytomegalovirus accounted for thefirst place, followed by epstein-barr virus. Most children with infection ofCytomegalovirus are infants, and most children with infection of epstein-barr virusare older children.2.There were no clinical symptoms present in early liver dysfunction, but insevere liver dysfunction, jaundice and liver and/or spleen enlargement were present. 3.Most liver dysfunction of children was mild.4. The prognosis of most children with liver dysfunction is good, very few ofthem develop to liver failure, once the children develop liver failure, the prognosis ispoor, and mortality is high. |
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