Elevated Bile Acids in Newborns with Biliary Atresia (BA) 英文参考文献.docVIP

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Elevated Bile Acids in Newborns with Biliary Atresia (BA) 英文参考文献.doc

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Elevated Bile Acids in Newborns with Biliary Atresia (BA) 英文参考文献

ElevatedBileAcidsinNewbornswithBiliaryAtresia(BA) KejunZhou1,2,3.,NaLin3,4.,YongtaoXiao1,2,3,YangWang1,2,3,JieWen1,2,3,Gang-MingZou1,2,3 XueFanGu3,4,WeiCai1,2,3 , * 1Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China, 2Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China, 3Shanghai Institute of Pediatric Research, Shanghai, China, 4Department of Pediatrics, Xinhua Hospital, School of Medicine,ShanghaiJiaoTongUniversity,Shanghai,China Abstract Biliary Atresia (BA), a result from inflammatory destruction of the intrahepatic and extrahepatic bile ducts, is a severe hepatobiliarydisorderuniquetoinfancy.EarlydiagnosisandKasaioperationgreatlyimprovetheoutcomeofBApatients, which encourages the development of early screening methods. Using HPLC coupled tandem mass spectrometry, we detected primary bile acids content in dried blood spots obtained from 8 BA infants, 17 neonatal jaundice and 292 comparisoninfantsat3–4daysoflife.Taurocholate(TC)wassignificantlyelevatedinbiliaryatresiainfants(0.9860.62mmol/ L) compared to neonatal jaundice (0.4760.30mmol/L) and comparison infants (0.4360.40mmol/L), with p=0.0231 and p=0.0016 respectively. The area under receiver operating characteristic (ROC) curve for TC to discriminate BA and comparisoninfantswas0.82(95%confidenceinterval:0.72–0.92).Acutoffof0.63 mmol/Lproducedasensitivityof79.1% andspecificityof62.5%.TheconcentrationsoftotalbileacidswerealsoraisedsignificantlyinBAcomparedtocomparison infants (6.6263.89mmol/L vs 3.8163.06mmol/L, p=0.0162), with the area under ROC curve of 0.75 (95% confidence interval:0.61–0.89).Nosignificantdifferencewasfoundbetweenthebileacidsofneonataljaundiceandthatofcomparison infants.TheearlyincreaseofbileacidsindicatesthepresentationofBAintheimmediatenewbornperiodandthepossibility ofTCasnewbornscreeningmarker. Citation: ZhouK,LinN, Xiao Y, WangY, WenJ,et al.(2012) Elevated Bile Acids inNewborns w