Archives De Pediatrie最新文献_第9页

Efficacy and tolerance of neostigmine to improve digestive motility in neonates after gastroschisis surgery 新斯的明改善胃裂术后新生儿消化功能的疗效和耐受性：新斯的明改善新生儿消化功能的疗效和耐受性。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.05.013

Lucy Carriat , Huu Kim An N’Guyen , Marion Honnorat , Franck Plaisant , Marine Butin

Background

The management of gastroschisis involves immediate surgery and post-surgery nutritional management. Ileus is a frequent complication, leading to difficulties in establishing enteral feeding. Parasympathomimetic agents, including neostigmine, are safely used in case of ileus in adults. Neostigmine was used in a single neonatal intensive care unit (NICU) for the management of ileus after gastroschisis repair.

Objective

The aim of this study was to report this experience of neostigmine use to improve digestive motility and its tolerance.

Methods and settings

This is an observational study from electronic health records (EHRs) that included all infants born with gastroschisis and treated with neostigmine in a NICU in Lyon, France, between June 2009 and December 2023. The primary outcome was the time to achieve effective enteral nutrition after the introduction of neostigmine. Secondary outcomes of tolerance and efficacy were also collected from the medical records. This study received approval from an ethics committee.

Results

Among 86 patients with gastroschisis, 16 patients received neostigmine due to either large volumes of gastric residue or absence of transit. They received neostigmine at a median (IQR) of 13.5 (12;17.25) days of life. Effective enteral feeding was achieved after a median of 11 (5.75;13) days of neostigmine treatment. Neostigmine was well tolerated, apart from one case of a serious but quickly resolved adverse event after intravenous administration.

Conclusions

The use of oral neostigmine in neonates with gastroschisis appears to be effective and safe. Larger prospective studies are required to determine its possible place in the management of these newborns.

背景：胃裂的治疗包括立即手术和术后营养管理。肠梗阻是一种常见的并发症，导致肠内喂养困难。拟副交感神经药物，包括新斯的明，可安全用于成人肠梗阻。新斯的明用于单一新生儿重症监护病房（NICU）胃裂修复后肠梗阻的管理。目的：本研究的目的是报告新斯的明用于改善消化运动及其耐受性的经验。方法和背景：这是一项来自电子健康记录（EHRs）的观察性研究，该研究包括2009年6月至2023年12月期间在法国里昂NICU出生并接受新斯的明治疗的所有胃裂患儿。主要观察指标是引入新斯的明后获得有效肠内营养的时间。从医疗记录中也收集了耐受性和疗效的次要结局。这项研究得到了伦理委员会的批准。结果：86例胃裂患者中，有16例患者因胃残量大或胃未经过而接受新斯的明治疗。他们在平均寿命（IQR）为13.5（12;17.25）天时接受新斯的明治疗。新斯的明治疗中位数为11（5.75;13）天，肠内喂养有效。新斯的明耐受性良好，除了一例静脉给药后严重但迅速解决的不良事件。结论：口服新斯的明治疗新生儿胃裂是安全有效的。需要更大的前瞻性研究来确定其在这些新生儿管理中的可能位置。

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引用次数: 0

General practitioners' knowledge and management of children co-victimized by intimate partner violence 全科医生对共同遭受亲密伴侣暴力的儿童的了解和管理。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.04.004

Justine Launey , Bernard Brau , Mathieu Kuchenbuch , Martine Balençon

Background

Intimate partner violence (IPV) is a major global public health issue, frequently impacting children as secondary victims. However, research on the involvement of general practitioners (GPs) in identifying and managing children exposed to IPV in France is lacking.

Objective

This study aimed to assess GPs' knowledge and practices regarding child protection in IPV cases, shedding light on gaps in their training and practices.

Methods and Settings

An electronic survey was conducted among GPs in Bretagne from May 2020 to May 2022, assessing demographic characteristics, clinical experiences, management practices for children exposed to IPV, and understanding its impact on children and adolescents.

Results

The study involved 91 GPs (sex ratio: 0.34, median: 15 [interquartile: 5.75–23] years of practice experience, and 25 % [18–30] of their practice focused on paediatrics). Results showed that 67 % encountered IPV situations within the past year, 46 % of children were in danger (2[1–2] per practitioner), and 48 % of children lived in a family with IPV (2[1–3] per practitioner). Thirty-five percent of GPs observed children exposed to IPV without recognizing them as endangered. Regarding knowledge of the impact of IPV on children, practitioners rated it at 5 out of 10, expressing discomfort (Likert scale from 0 to 10 (LS_0–10): 4[3:5]) and perceiving their training as inadequate (LS_0–10: 3[2:4]). They emphasized the need for better stakeholder understanding, favoring in-person training and enhanced access to specialized consultations to enhance their expertise.

Conclusion

These findings highlight the critical role of GPs in identifying and managing children exposed to IPV in France, despite gaps in knowledge and practice. Strengthening GPs’ training, standardizing protocols, improving and developing access to specialized consultations, such as hospital-based Unit for Endangered Children (“Unité d’Accueil Pédiatrique Enfant en Danger”, UAPED), and fostering interprofessional collaboration could enhance child protection efforts in IPV contexts.

背景：亲密伴侣暴力（IPV）是一个重大的全球公共卫生问题，儿童经常作为次要受害者受到影响。然而，关于全科医生（gp）参与识别和管理暴露于IPV的儿童在法国的研究是缺乏的。目的：本研究旨在评估全科医生在IPV案件中关于儿童保护的知识和实践，揭示他们在培训和实践中的差距。方法和环境：于2020年5月至2022年5月对布列塔尼全科医生进行电子调查，评估暴露于IPV儿童的人口统计学特征、临床经验、管理实践，并了解其对儿童和青少年的影响。结果：该研究涉及91名全科医生（性别比：0.34，中位数：15[四分位数间：5.75-23]年的执业经验，25%[18-30]的执业集中在儿科）。结果显示，67%的儿童在过去一年内遇到IPV情况，46%的儿童处于危险之中（每名从业人员2例[1-2]），48%的儿童生活在有IPV的家庭（每名从业人员2例[1-3]）。35%的全科医生观察到暴露于IPV的儿童，但没有意识到他们处于危险之中。关于IPV对儿童影响的知识，从业人员将其评为5分（满分为10分），表示不适（李克特量表从0到10 (LS0-10): 4[3:5]），并认为他们的培训不足（LS0-10: 3[2:4]）。他们强调需要增进利益攸关方的了解，支持面对面培训和增加获得专门咨询的机会，以提高他们的专业知识。结论：尽管在知识和实践方面存在差距，但这些发现突出了全科医生在识别和管理法国暴露于IPV的儿童方面的关键作用。加强全科医生的培训，使协议标准化，改善和发展获得专门咨询的机会，例如医院的濒危儿童救助单位，以及促进专业间的合作，可以加强在IPV情况下的儿童保护工作。

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引用次数: 0

Urinary follicle-stimulating hormone during triptorelin stimulation test can monitor the efficacy of triptorelin depot in girls with precocious or early puberty 雷普多雷林刺激试验期间的尿卵泡刺激素可监测雷普多雷林库在性早熟或性早熟女孩中的疗效。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.06.003

Yuan Zhou , Beilei Zeng , Yinyin Huang , Panwang Huang , Ye Li , Zhuangjian Xu , Yaping Ma

Background

There is still no consensus on simple methods to monitor the effectiveness of gonadotropin-releasing hormone analogs in girls with precocious or early puberty.

Objective

To evaluate the value of urinary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) before and after triptorelin stimulation test detected by immunochemiluminometric assay (ICMA) to monitor the efficacy of triptorelin depot in girls with precocious or early puberty.

Methods

A total of 128 girls with precocious or early puberty were included, of whom 81 received triptorelin depot treatment (3.75 mg). Triptorelin (100 μg) stimulation tests were performed before and after 3 months treatment. The time of triptorelin stimulation test was designated as 0 h. Timed 12 h urine with recorded urine volume was collected before and after the test, defined as diurnal spontaneous (-24 h to -12 h), nocturnal spontaneous (-12 h to 0 h), diurnal stimulated (0 h to 12 h), and nocturnal stimulated urine (12 h to 24 h), respectively. LH and FSH were assayed by ICMA.

Results

After 3 months of treatment, 67 girls completed sample collections, with 2 out of 67 girls experiencing inadequate efficacy. Serum and urinary gonadotropin levels decreased significantly after 3 months of treatment. The area under curve (AUC) of nocturnal spontaneous, diurnal stimulated, and nocturnal stimulated urinary FSH (UFSH) concentrations in determining efficacy were 0.962, 0.985, and 0.954. The three AUCs were all greater than serum peak LH (PLH, 0.746) or peak FSH (PFSH, 0.931). When nocturnal spontaneous, diurnal stimulated, and nocturnal stimulated UFSH concentrations were ≤ 5.24 IU/L, 6.94 IU/L, and 5.78 IU/L, the sensitivity was 93.8 %, 96.9 % and 95.4 %, and the specificity was all 100.0 %.

Conclusion

UFSH measured by ICMA from diurnal and nocturnal stimulated 12-hour urine samples can be used to assess the effectiveness of triptorelin depot in girls with precocious or early puberty. For a non-invasive and cost-effective option, spontaneous nocturnal urine may also be a suitable choice.

背景：对于监测促性腺激素释放激素类似物在性早熟或性早熟女孩中的有效性的简单方法仍未达成共识。目的：评价免疫化学发光法（ICMA）检测雷普雷林刺激试验前后的促黄体生成素（LH）和促卵泡激素（FSH）对监测雷普雷林治疗在性早熟或性早熟女孩中的疗效的价值。方法：纳入128例性早熟或性早熟女童，其中81例接受雷普妥林储备治疗（3.75 mg）。治疗3个月前后分别进行雷普妥林（100 μg）刺激试验。雷喜素刺激试验时间为0 h，试验前后收集记录尿量的定时12 h尿，分别定义为昼自发尿（-24 h至-12 h）、夜自发尿（-12 h至0 h）、昼刺激尿（0 h至12 h）、夜刺激尿（12 h至24 h）。采用ICMA法测定LH和FSH。结果：治疗3个月后，67名女孩完成了样本采集，67名女孩中有2名疗效不足。治疗3个月后血清和尿促性腺激素水平明显下降。夜间自发尿促卵泡刺激素、夜间刺激尿促卵泡刺激素和夜间刺激尿促卵泡刺激素测定疗效的曲线下面积（AUC）分别为0.962、0.985和0.954。3个auc均大于血清LH峰（PLH, 0.746）或FSH峰（PFSH, 0.931）。当夜间自发、日间刺激和夜间刺激UFSH浓度≤5.24 IU/L、6.94 IU/L和5.78 IU/L时，敏感性分别为93.8%、96.9%和95.4%，特异性均为100.0%。结论：用ICMA法测定每日和夜间刺激12小时尿液样本的UFSH可用于评价雷普妥林储库治疗性早熟或性早熟女孩的有效性。作为一种非侵入性和成本效益的选择，自发夜间尿也可能是合适的选择。

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引用次数: 0

Preliminary proposals for the follow-up of infants born to mothers with cystic fibrosis treated with CFTR modulators during the first two years of life 对囊性纤维化母亲在出生后两年内接受CFTR调节剂治疗的婴儿进行随访的初步建议

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.03.005

Philippe Reix , Camille Audousset , Emmanuelle Girodon , Isabelle Sermet Gaudelus , Sophie Gautier

The number of pregnancies in women with cystic fibrosis (CF) has significantly increased in recent years, leading to a corresponding rise in the number of healthy infants exposed to cystic fibrosis transmembrane conductance regulator modulator (CFTRm) such as elexacaftor-tezacaftor-ivacaftor (ETI) or Kaftrio/Kalydeco® (K/K) triple therapy. Currently, data on the immediate outcomes for these children is reassuring; however, some cases of abnormal liver tests and cataracts have been reported in a few newborns indirectly exposed to ETI in utero or postnatally. Long-term neurodevelopment remains a concern that requires further investigation.

A working group from the Société Française de la Mucoviscidose has developed recommendations for monitoring these children during the first two years and beyond. Given the increasing number of infants born to mothers taking CFTR modulators, as well as questions regarding their immediate care during the maternity stay and the feasibility of breastfeeding, it is crucial for pediatricians to be aware of these recommendations, which are based on a comprehensive review of the literature.

近年来，囊性纤维化（CF）妇女的怀孕数量显著增加，导致健康婴儿接受囊性纤维化跨膜传导调节剂（CFTRm）如elexacaftor-tezacaftor-ivacaftor （ETI）或Kaftrio/Kalydeco®（K/K）三联治疗的数量相应增加。目前，关于这些儿童的直接结果的数据令人放心；然而，据报道，一些在子宫内或出生后间接暴露于ETI的新生儿出现肝脏检查异常和白内障的病例。长期的神经发育仍然是一个需要进一步研究的问题。法国社会卫生组织的一个工作组已经制定了在头两年及以后监测这些儿童的建议。考虑到服用CFTR调节剂的母亲所生婴儿数量的增加，以及有关产妇住院期间的即时护理和母乳喂养可行性的问题，儿科医生了解这些基于文献综合综述的建议至关重要。

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引用次数: 0

Much ado about … the fetal heart examination during the first trimester.What to expect from the new French obstetrical imaging guidelines? 孕早期的胎儿心脏检查太麻烦了。我们对新的法国产科影像指南有什么期待？

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.05.006

Daniela Laux , Alexandre J. Vivanti

引用次数: 0

Recommendations for mountain travel and altitude acclimation in pediatric populations: a French Delphi study 儿童山区旅行和高原适应的建议：法国德尔菲研究。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.05.007

Clémence Rascle , Pauline Connan , Corentin Tanné

Objective

To develop recommendations for mountain travel and altitude acclimation for children under 3 years old by convening a committee of experts.

Methods

Using the DELPHI method, we collected proposals via email from professionals specializing in altitude and related pathologies. Experts were asked about the maximum suggested altitude and specific recommendations.

Results

Sixteen experts participated in the study. The main recommendations included a maximum altitude of 2000 meters for children under 1 year old and 2500 meters for children under 3 years old, a gradual ascent with stops every 500 meters, and careful monitoring of the child's reactions. Absolute contraindications were noted for cable car ascents in children under 1 year old, with relative contraindications for those under 3 years old. It was also recommended to consult a doctor before traveling to high altitudes if the child has a risk-related pathology and to limit winter outdoor activities to short durations with appropriate clothing.

Conclusion

This survey revealed a consensus on the recommended maximum travel altitude for children and provided various guidelines to mitigate the effects of altitude.

目的：召开专家委员会，为3岁以下儿童制定山地旅行和高原适应建议。方法：采用德尔菲法，通过电子邮件收集高原及相关病理专家的建议。专家们被问及建议的最大海拔高度和具体建议。结果：16位专家参与研究。主要建议包括1岁以下儿童的最大海拔高度为2000米，3岁以下儿童的最大海拔高度为2500米，每500米停止一次逐渐上升，并仔细监测儿童的反应。1岁以下儿童缆车攀登的绝对禁忌症，3岁以下儿童缆车攀登的相对禁忌症。如果孩子有风险相关的病理，建议在去高海拔地区旅行前咨询医生，并建议冬季户外活动限制在短时间内，穿适当的衣服。结论：本调查对儿童的推荐最大旅行高度达成了共识，并提供了减轻海拔影响的各种指导方针。

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引用次数: 0

Non-compliance with post-discharge vitamin D intake guidelines: an observational study in an overseas French maternity ward 不遵守出院后维生素D摄入指南：一项法国海外产科病房的观察性研究。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.04.005

Mathis Thia , Simon Lorrain , Magali Richard , Alexandre Lapillonne , Silvia Iacobelli

Background

Studies in tropical countries revealed a high prevalence of vitamin D insufficiency. The French recommendations did not differentiate between overseas and mainland areas in terms of vitamin D intake. However, the prevalence of vitamin D supplementation in infants in the French overseas territories is unknown.

Aims

The primary objective of the study was to assess the prevalence of vitamin D supplementation in infants aged 4 to 9 months in a tropical overseas region. Secondary objectives were to assess compliance, adherence and factors influencing vitamin D supplementation.

Material and methods

We conducted a cross-sectional study of infants born in La Réunion, a French overseas department in Indian Ocean. We interviewed the parents of all newborns born at term during a three-month period in 2022.

Results

Among the 323 term infants included, the prevalence of vitamin D supplementation at 4 to 9 months of age was 52 %. Compliance to guidelines was 44.3 %. Factors that were significantly and positively associated with vitamin D use at 4 to 9 months of age were: information about vitamin D supplementation by caregivers before leaving the maternity ward, subscription to a supplementary health insurance, and follow-up by a pediatrician. Infants whose parents reported colic and the use of supplements were significantly more likely to discontinue vitamin D supplementation

Conclusion

Vitamin D supplementation in these infants born in an overseas territory was not in line with current national recommendations.

背景：热带国家的研究表明，维生素D缺乏的患病率很高。法国的建议在维生素D摄入量方面没有区分海外和大陆地区。然而，在法国海外领地的婴儿中维生素D补充剂的普及程度尚不清楚。目的：该研究的主要目的是评估热带海外地区4至9个月婴儿补充维生素D的流行程度。次要目的是评估依从性、依从性和影响维生素D补充的因素。材料和方法：我们对在印度洋的法国海外科La r出生的婴儿进行了横断面研究。我们采访了2022年三个月期间所有足月新生儿的父母。结果：在323名足月婴儿中，在4至9个月大时补充维生素D的患病率为52%。对指导方针的依从性为44.3%。与4到9个月大的婴儿使用维生素D有显著正相关的因素是：在离开产科病房前护理人员提供的维生素D补充信息、补充健康保险的订阅以及儿科医生的随访。父母报告有肠绞痛和服用补充剂的婴儿明显更有可能停止补充维生素D结论：在海外出生的这些婴儿补充维生素D不符合目前的国家建议。

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引用次数: 0

Clinical features, treatment and outcomes of acute ethmoiditis: A case series of 20 hospitalized children 急性筛炎的临床特点、治疗和预后：20例住院儿童的病例分析。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.04.002

Sarah Salameh , Noémie Lachaume , Alexandra Bisca , Manon Beauvais , Adrien Chaud , Marie Cotillon , Laure Cohen , Romain Basmaci

We described 20 children hospitalized with acute ethmoiditis between 2017 and 2022 in our center. Median age was 3.5 years, fifteen were Chandler’s group II and three were group III. Despite adequate antibiotic therapy regarding national antibiotic treatment guidelines, six (30 %) patients experienced poor outcomes; five of them required surgical drainage, reinforcing the need of close surveillance of these children.

我们描述了2017年至2022年在我们中心因急性筛炎住院的20名儿童。中位年龄为3.5岁，15例为钱德勒组，3例为第三组。尽管根据国家抗生素治疗指南进行了充分的抗生素治疗，但6名（30%）患者的预后不佳；其中5例需要手术引流，加强了对这些儿童密切监测的必要性。

引用次数: 0

Prevalence of risk factors for developing childhood obesity in maternity 产妇发生儿童肥胖的危险因素的流行情况。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.04.001

Hélène Thibault , Marie Pailler , Caroline Carriere , Pascal Barat , Mélanie Le Goff , Nadira Ghemini , Loic Sentilhes , Muriel Rebola , Vincent Rigalleau , Thierry Lamireau

Background

During the perinatal period several maternal and obstetric risk factors are known to be associated with overweight and childhood obesity.

Method

The aim of this study was to determine the prevalence of risk factors for childhood obesity identifiable at birth. Data extracted from the computerized medical record (DXCARE^R) women who gave birth in the maternity ward of the University hospital of Bordeaux during a 11 months-period constituted an anonymized database to calculate the prevalence of the following risk factors: maternal obesity prior to pregnancy, excessive weight gain during pregnancy, maternal smoking, gestational diabetes, low socioeconomic status, cesarean delivery, macrosomia, and lack of breastfeeding. After eliminating duplicates and women for whom data on risk factors were missing, the population available for analysis was 1977 women who responded to inclusion criteria.

Results

At the onset of pregnancy, mean age of women was 31.6 years [± 5.2] and mean BMI was 23.9 kg / m² [± 4.9], a third of them being overweight or obese. During pregnancy, half of women had excessive weight gain, gestational diabetes occurred in 15.9 % of them, 15.9 % smoked, and 18.1 % were in a precarious situation. Children were born by cesarean section in 15.3 % of cases. Depending on the definition used, exact birth weight (BW) or Audipog formula (percentile), neonates were large for gestational age in respectively 6.7 % of cases (BW> 4000 g) or 11 % (> 90th percentile) and small for gestational age in respectively 3 % of cases (BW <2500 g) and 6.8 % (<10th percentile). They were formula fed in 28.7 % of cases. The multivariate analysis showed that the association between excessive weight gain during pregnancy and birth weight is influenced by all other risk factors, except breastfeeding.

Conclusion

Risk factors for developing childhood obesity, which are largely interrelated and influenced by medical care, can be identified as early as the maternity ward. Based on their prevalence, the development of a risk score will make it possible to set up an intervention program for the early prevention of childhood obesity right from the maternity ward.

背景：在围产期，已知一些孕产妇和产科危险因素与超重和儿童肥胖有关。方法：本研究的目的是确定出生时可识别的儿童肥胖危险因素的患病率。从计算机医疗记录（DXCARER）中提取的11个月期间在波尔多大学医院产科病房分娩的妇女的数据构成了一个匿名数据库，以计算以下危险因素的患病率：孕妇孕前肥胖、孕期体重过度增加、孕妇吸烟、妊娠糖尿病、低社会经济地位、剖宫产、巨大儿和缺乏母乳喂养。在排除重复和缺少风险因素数据的妇女后，可用于分析的人口是符合纳入标准的1977名妇女。结果：孕妇开始妊娠时平均年龄为31.6岁[±5.2]，平均BMI为23.9 kg / m²[±4.9]，其中1 / 3为超重或肥胖。在怀孕期间，一半的妇女体重过度增加，其中15.9%发生妊娠糖尿病，15.9%吸烟，18.1%处于不稳定状态。剖宫产占15.3%。根据所使用的定义，确切的出生体重（BW）或Audipog公式（百分位数），新生儿胎龄大的分别为6.7% （BW - 4000克）或11% （BW - 90百分位数），胎龄小的分别为3% （BW）。结论：发生儿童肥胖的危险因素在很大程度上是相互关联的，并受医疗保健的影响，可以早在产科病房发现。基于他们的患病率，风险评分的发展将有可能建立一个干预方案，从产科病房开始早期预防儿童肥胖。

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引用次数: 0

Reference values for liver stiffness in children using shear-wave elastography 用剪切波弹性成像测量儿童肝脏硬度的参考值。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.03.006

Célia Charlier , Saskia Vande Perre , Béatrice Dubern , Claire Apte-Dubuisson , Etienne Audureau , Margaux Bertrand , Hubert Ducou le Pointe , Eléonore Blondiaux

Background

Ultrasound shear wave elastography (SWE) measures liver stiffness non-invasively in chronic liver diseases. Reference values in healthy children by age are needed in clinical practice.

Objectives

Our study aimed to measure the reference values for liver elasticity by 2D SWE in a pediatric population stratified by age.

Materials and methods

This retrospective study included 266 children without liver disease referred for an abdominal or renal ultrasonography from February 2022 to April 2022. Shear wave elasticity and shear wave speed were measured with a convex (6C1) or linear (SL15–4) transducer with a Canon Aplio 500 Aplio system performed for another reason in healthy children aged 0 to 19 years distributed in five age groups.

Results

Median liver elasticity value was 5.50 kPa (interquartile range [IQR] 4.9–6.3) overall. Global analyses revealed values decreasing with increasing age from newborn to adolescence (elasticity: 6.0 kPa [IQR 5.4–6.5] to 5.3 kPa [IQR 4.7–6.4]; speed: 1.41 m/s [IQR 1.34–1.47] to 1.33 m/s [IQR 1.27–1.46], p < 10^–3). Elasticity values were lower with the convex than linear transducer (5.20 kPa [IQR 4.7–5.8] vs 6.2 kPa [IQR 5.6–6.6], p < 10^–4). Elasticity values increase with increasing age if we study each probe individually (from 1 year old to older). Median elasticity values were not associated with sex after adjustment for age or with BMI.

Conclusion

Our study provides reference values for liver elasticity in healthy children by age and for two probes using an Aplio system. Liver elasticity values differed according to the probe used.

背景：超声剪切波弹性成像（SWE）在慢性肝病中无创测量肝脏硬度。临床需要按年龄划分的健康儿童的参考值。目的：我们的研究旨在通过2D SWE在按年龄分层的儿科人群中测量肝脏弹性的参考值。材料和方法：本回顾性研究包括266名无肝脏疾病的儿童，于2022年2月至2022年4月进行腹部或肾脏超声检查。横波弹性和横波速度用凸（6C1）或线性（SL15-4）换能器和佳能Aplio 500 Aplio系统测量，在分布在五个年龄组的0至19岁的健康儿童中进行。结果：肝脏弹性中位数为5.50 kPa（四分位间距[IQR] 4.9-6.3）。全球分析显示，从新生儿到青春期，弹性值随着年龄的增加而降低(弹性：6.0 kPa [IQR 5.4-6.5]至5.3 kPa [IQR 4.7-6.4]；速度：1.41 m/s [IQR 1.34-1.47] ~ 1.33 m/s [IQR 1.27-1.46], p < 10-3)。与线性换能器相比，凸形换能器的弹性值较低（5.20 kPa [IQR 4.7-5.8] vs 6.2 kPa [IQR 5.6-6.6], p < 10-4）。如果我们单独研究每个探针（从1岁到更大），弹性值随着年龄的增长而增加。调整年龄或BMI后，中位弹性值与性别无关。结论：本研究为不同年龄的健康儿童的肝脏弹性提供了参考价值，并为两种探针的应用提供了参考价值。肝弹性值因所用探针不同而不同。

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引用次数: 0