Investigation Of Risk Factors Associated With Biliary Atresia And Analysis Of Early Screening Indexes

Objective: Biliary atresia is the most common cause of obstructive jaundice in newborns in China.It is characterized by progressive inflammation and fibrosis obstruction of the intrahepatic and extrahepatic bile ducts.It is a fatal hepatobiliary system disease in infants and young children.Studies have shown that biliary atresia is related to geographical,ethnic,and gender factors.At present,there is a lack of relevant epidemiological surveys in China,which is not conducive to the study of its etiology and pathogenesis.On the other hand,the current etiology and pathogenesis of biliary atresia remain unclear.There is no effective early screening for specific markers,and laparotomy and intraoperative cholangiography are still required for diagnosis.Therefore,biliary atresia and other neonatal jaundice are clinically diagnosed.Sexual diseases are often difficult to identify.Therefore,it is very necessary to investigate the risk factors related to biliary atresia and to find effective screening indicators for early biliary atresia.This study combines domestic and international literature studies to report risk factors associated with biliaryatresia.A uniform questionnaire was designed to collect information on the child's own,mother 's,father 's,and environmental factors.At the same time,maternal prenatal and post-hospital examination data were collected.,Statistical analysis of the risk factors associated with biliary atresia and early effective screening indicators provide possible clues for the early differential diagnosis and the study of its etiology and pathogenesis.Methods:1.Comprehensive domestic and international literature research reports on the design of biliary atresia risk factor questionnaires,including the child's own,mother,father,and environmental factors and other indicators,from July 2016 to February 2018 in the Children's Hospital of Chongqing Medical University,liver and gallbladder Patients under 8 months of age who were hospitalized for jaundice due to unexplained reasons underwent questionnaires at the time of admission.The clinical data of all investigated subjects were taken from the disease records to determine the biliary atresia group and the control group.After univariate analysis was performed,multivariate logistic regression analysis was performed using the indicator with P<0.05 as the independent variable,and the correlation between various factors in the questionnaire and biliary atresia was examined.2.Collect the data of four-dimensional color Doppler sonography during pregnancy,routine hematology and imaging data during hospitalization,determine the biliary atresia group and control group,andperform statistical analysis on the above data to find meaningful diagnostic indicators.Diagnostic values are compared.Results: 1.Questionnaire survey of 261 cases,all questionnaires were returned to meet the biliary atresia group,control group inclusion and exclusion criteria were 148 cases and 91 cases,and another 22 cases did not meet the inclusion criteria were not included in the study.Univariate analysis showed that gender,gestational age,birth weight,presence or absence of adverse events at birth,feeding methods,presence or absence of lighter stool color,mother's gestational diabetes,local economic level,etc.Meaning.Multivariate Logistic regression analysis showed that there were statistically significant differences in the three indicators of low birth weight,lighter stool color,and gestational diabetes in the mother.Among them,low birth weight was an independent protective factor for biliary atresia(P<0.01,OR=0.16,95%CI: 0.05-0.45),shallow stool color,and gestational diabetes mothers were independent risk factors for biliary atresia(P< 0.01,OR=5.78,95% CI: 3.05 to 10.95;P=0.04,OR=4.05,95%CI: 1.06 to 15.53).2.In the analysis of clinical examination data,the abnormality of the four-dimensional ultrasound biliary system during pregnancy and the abnormalities of the biliary system of the abdomen after the admission in the biliary atresia group were significantly higher than those in the nonbiliary atresia group(P=0.04,12.2% vs 4.4.%;P.<0.01,96.6% vs 46.6%).The total bilirubin,direct bilirubin,total protein,globulin,alanine aminotransferase,aspartate aminotransferase,?-glutamyl transpeptidase,total cholesterol,triglyceride and other 9 indicators were significantly higher than those in the biliary atresia group.In the biliary atresia group(P<0.01,P <0.01,P <0.01,P = 0.02,P <0.01,P <0.01,P <0.01,P = 0.03,P<0.01),high-density lipoprotein was significantly in the biliary atresia group Lower than the non-biliary atresia group(P <0.01).For the above indicators that were statistically different between the two groups and the level of biliary atresia was significantly higher than that of the non-biliary atresia group,the ROC curve was further analyzed.The results showed that TBIL,DBIL,ALT,AST,GGT,TC,TG,etc.The 7 indicators were significantly different between the two groups.The diagnosis of biliary atresia was statistically significant.The diagnosis values ??from high to low were: DBIL> GGT> ALT> AST> TG> TBIL> TC.Conclusions: 1.Low birth weight is an independent protective factor for biliary atresia,lighter stool color and mothers with gestational diabetes are independent risk factors for biliary atresia.2.The abnormality of the four-dimensional color Doppler ultrasound system during pregnancy and the abnormalities of the biliary system of the abdomen after coloring in the biliary atresia group were significantly higher than that of the non-biliary atresia group,which was of great value in the early diagnosis of biliary atresia.3.The indexes of TBIL,DBIL,ALT,AST,GGT,TC,TG and so on are statistically significant for the diagnosis of biliary atresia.The order of diagnosis from high to low is: DBIL> GGT> ALT> AST> TG> TBIL>TC.