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为了探讨先天性胆道闭锁(CBA)的原因,分析肝脏病理变化、临床预后与巨细胞病毒(CMV)感染的关系。取14例CBA患儿术中肝脏及肝门淋巴结标本,一份进行多聚酶链反应巨细胞病毒基因(PCR-CMV-DNA)检测,另一份肝脏标本做HE染色光镜检查。结果:14例中CMV阳性占8例。肝脏病理检查表明随手术时日龄增加,胆管增生明显。比较CMV阳性组与CMV阴性组肝细胞病变、淤胆无差异,肝纤维化CMV阴性组重于阳性组;肝细胞坏死CMV阳性组重于阴性组。随访8~20个月,生存6例,其中CMV阳性5例,死亡8例。CMV感染可能是CBA的病因之一,肝纤维化程度、术后胆管炎发生的频率和程度与预后关系密切。从临床归转看CMV感染阳性组预后较好。
To investigate the causes of congenital biliary atresia (CBA), the relationship between liver pathological changes, clinical prognosis and cytomegalovirus (CMV) infection was analyzed. Fourteen patients with CBA underwent liver and hepatic portal lymph node specimens. One was detected by PCR-CMV-DNA and the other was examined by HE staining. Results: CMV positive in 14 cases accounted for 8 cases. Liver pathological examination showed that with the increase of age at surgery, bile duct hyperplasia. CMV positive group and CMV negative group of hepatocellular lesions, cholestasis no difference in liver fibrosis CMV negative group than in the positive group; hepatocyte necrosis CMV positive group was heavier than the negative group. Follow-up 8 to 20 months, 6 patients survived, including CMV-positive in 5 cases, 8 cases of death. CMV infection may be one of the causes of CBA, the degree of liver fibrosis, the frequency and extent of postoperative cholangitis and prognosis are closely related. CMV infection from the clinical reversion positive group prognosis is good.