PDF(Pubmed)
Abstract：
UNASSIGNED: The study was aimed to find out the efficacy of a stool color card (SCC) in differentiating biliary atresia (BA) from non-BA in resource-limited countries.
UNASSIGNED: stool color screening system was introduced in 2004 which lead to marked improvement in sensitivity of detecting BA.
UNASSIGNED: This cross-sectional observational study was conducted from January, 2019 through July, 2022 on purposively sampled infants who developed jaundice before three months of age, had direct bilirubin of > 20 % of total with pale stool and dark urine.
UNASSIGNED: 144 cases (male, 96) were included in the study and their mean age at admission was 87.3±37.2 days and mean age at onset of jaundice was 6.1±7.7 days. BA was confirmed in 106 (73.6%) cases and 38 (26.4%) children were in non-BA group. Frequency of persistent pale stool between BA and non- BA were 88 vs 8 (83.0 % Vs 21.0 %) which was highly significant (p=0.000). Mean difference of total and direct serum bilirubin, median alanine transferase and alkaline phosphatase were not statistically significant between two groups. Median of serum gamma glutamyl transpeptidase (GGT) in BA was 570 U/L and in non-BA it was 138.0 U/L which was statistically significant (p=0.000). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of SCC were 83%, 78.9%, 91.7%, 62.5% and 81.9% respectively.
UNASSIGNED: SCC has good sensitivity to diagnose BA but failed to prove better specificity to rely simply on it. SCC may be used as early screening tool for prompt referral to appropriate medical care centers for final evaluation of BA.
UNASSIGNED: stool color screening system was introduced in 2004 which lead to marked improvement in sensitivity of detecting BA.
UNASSIGNED: This cross-sectional observational study was conducted from January, 2019 through July, 2022 on purposively sampled infants who developed jaundice before three months of age, had direct bilirubin of > 20 % of total with pale stool and dark urine.
UNASSIGNED: 144 cases (male, 96) were included in the study and their mean age at admission was 87.3±37.2 days and mean age at onset of jaundice was 6.1±7.7 days. BA was confirmed in 106 (73.6%) cases and 38 (26.4%) children were in non-BA group. Frequency of persistent pale stool between BA and non- BA were 88 vs 8 (83.0 % Vs 21.0 %) which was highly significant (p=0.000). Mean difference of total and direct serum bilirubin, median alanine transferase and alkaline phosphatase were not statistically significant between two groups. Median of serum gamma glutamyl transpeptidase (GGT) in BA was 570 U/L and in non-BA it was 138.0 U/L which was statistically significant (p=0.000). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of SCC were 83%, 78.9%, 91.7%, 62.5% and 81.9% respectively.
UNASSIGNED: SCC has good sensitivity to diagnose BA but failed to prove better specificity to rely simply on it. SCC may be used as early screening tool for prompt referral to appropriate medical care centers for final evaluation of BA.
摘要：
■该研究旨在发现在资源有限的国家中，粪便色卡（SCC）在区分胆道闭锁（BA）和非BA方面的功效。
■粪便颜色筛选系统于2004年推出，显着提高了检测BA的灵敏度。
■这项横断面观察研究从1月开始进行，2019年7月，2022年对三个月前出现黄疸的婴儿进行有目的地采样，直接胆红素>总胆红素的20％，粪便苍白和深色尿液。
■144例（男性，96）被纳入研究，他们入院时的平均年龄为87.3±37.2天，黄疸发作时的平均年龄为6.1±7.7天。在106例（73.6％）病例中确认了BA，在非BA组中确认了38例（26.4％）儿童。BA和非BA之间持续性苍白粪便的频率为88vs8（83.0％vs21.0％），这是非常显着的（p=0.000）。总胆红素和直接血清胆红素的平均差，两组间丙氨酸转移酶中位数和碱性磷酸酶中位数无统计学意义.BA中血清γ谷氨酰转肽酶（GGT）的中位数为570U/L，非BA中的中位数为138.0U/L，具有统计学意义（p=0.000）。敏感性,特异性，正预测值，SCC的阴性预测值和准确性为83%，78.9%,91.7%,分别为62.5%和81.9%。
■SCC对诊断BA具有良好的敏感性，但未能证明仅依靠它具有更好的特异性。SCC可用作早期筛查工具，以迅速转诊至适当的医疗中心，以进行BA的最终评估。
■粪便颜色筛选系统于2004年推出，显着提高了检测BA的灵敏度。
■这项横断面观察研究从1月开始进行，2019年7月，2022年对三个月前出现黄疸的婴儿进行有目的地采样，直接胆红素>总胆红素的20％，粪便苍白和深色尿液。
■144例（男性，96）被纳入研究，他们入院时的平均年龄为87.3±37.2天，黄疸发作时的平均年龄为6.1±7.7天。在106例（73.6％）病例中确认了BA，在非BA组中确认了38例（26.4％）儿童。BA和非BA之间持续性苍白粪便的频率为88vs8（83.0％vs21.0％），这是非常显着的（p=0.000）。总胆红素和直接血清胆红素的平均差，两组间丙氨酸转移酶中位数和碱性磷酸酶中位数无统计学意义.BA中血清γ谷氨酰转肽酶（GGT）的中位数为570U/L，非BA中的中位数为138.0U/L，具有统计学意义（p=0.000）。敏感性,特异性，正预测值，SCC的阴性预测值和准确性为83%，78.9%,91.7%,分别为62.5%和81.9%。
■SCC对诊断BA具有良好的敏感性，但未能证明仅依靠它具有更好的特异性。SCC可用作早期筛查工具，以迅速转诊至适当的医疗中心，以进行BA的最终评估。
