目的:探讨谷氨酰转肽酶(gamma-glutamyl transferase，GGT)<300 U/L临床疑诊为胆道闭锁患儿的临床特征。方法:收集2012年6月至2018年9月由广西医科大学第一附属医院儿科转至小儿外科收治的GGT<300 U/L临床疑诊为胆道闭锁的84例患儿的临床资料，根据术中胆道造影的诊断结果分为胆道闭锁组和胆汁淤积性肝炎组；其中确诊胆道闭锁33例(胆道闭锁组)，39.29%(33/84)，胆汁淤积性肝炎51例(胆汁淤积性肝炎组)，60.71%(51/84)。分析两组患儿在肝功能、胆固醇、血乳酸、血氨、血常规和肝脏病理学等方面的特点和差异。结果:胆道闭锁组就诊日龄及手术日龄显著高于胆汁淤积性肝炎组，差异具有统计学意义(n P<0.05)。胆道闭锁组GGT、总胆汁酸(total bile acid，TBA)值显著高于胆汁淤积性肝炎组，差异具有统计学意义(n P<0.05)。GGT和TBA的曲线下面积(area under the curve，AUC)分别为0.715和0.72；GGT、TBA值两项指标联合分析，AUC为0.739，诊断价值均为中等，所得阈值灵敏性及特异性均不高。胆道闭锁组肝纤维化的比例显著高于胆汁淤积性肝炎组，其中21.21%(7/33)的胆道闭锁患儿存在肝硬化，所有胆汁淤积性肝炎组的患儿无肝硬化，胆道闭锁组肝纤维化程度与就诊日龄、GGT呈正相关(n R＝0.503，n F＝6.321，n P＝0.001)。胆道闭锁肝组织胆栓形成和胆管增生均显著高于胆汁淤积性肝炎(n P<0.05)。n 结论:GGT<300 U/L的疑似胆道闭锁的患儿，建议早期进行肝组织病理学检查或剖腹探查提高诊断的准确率。“,”Objective:To evaluate the clinical features of children with suspected biliary atresia (BA) with gamma-glutamyl transferase (GGT) <300 U/L.Methods:A total of 84 suspected BA children with GGT <300 U/L were analyzed for clinical and biochemical data and routine postoperative liver histology from June 2012 to September 2018.Results:Based upon the results of intraoperative cholangiography, they were divided into BA and cholestatic hepatitis groups. The causes were BA (n=33, 39.29%) and cholestatic hepatitis (n=51, 60.71%). Age was significantly higher in BA group than that in cholestasis hepatitis group (n P<0.05). The values of GGT and total bile acid (TBA) were significantly higher in BA group than those in cholestatic hepatitis group (n P<0.05). The area under the ROC curve of GGT/TBA was 0.715 and 0.72 respectively. The values of GGT and TBA were combined for analysis. The area under the ROC curve was 0.739. The diagnostic value was medium and the threshold sensitivity and specificities were not high. The proportion of hepatic fibrosis was significantly higher in BA group than that in cholestatic hepatitis group. Among them, 7 cases (21.21%) of BA children had cirrhosis, no children with cholestatic hepatitis had cirrhosis and the degree of liver fibrosis in BA group and the day of treatment age, GGT was positively correlated (n R=0.503, n F=6.321, n P=0.001). Liver tissue and bile duct hyperplasia were significantly higher in BA than those in cholestatic hepatitis (n P<0.05).n Conclusions:Children of suspected BA with GGT <300 U/L are advised for liver pathology early or exploratory laparotomy for a diagnostic accuracy of BA.