Abstract: Abstract: Objective　To investigate the value of gamma-glutamyltransferase (GGT) combined with direct bilirubin (DBIL) and aspartate aminotransferase-to-platelet ratio index (APRI) in the diagnosis of biliary atresia (BA). Methods　The clinical data of 283 cases of infantile cholestatic hepatopathy were retrospectively analyzed. A total of 138 cases of BA confirmed by biliary exploration, cholangiography and liver biopsy were included in the BA group, and 145 cases of jaundice eliminated during operation or subsided after medical treatment were included in the non-BA group. The general information and the results of the first simultaneous hematological examination were collected, including age, sex, body weight, GGT, DBIL, indirect bilirubin (IBIL), total bile acid (TBA), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and platelet count (PLT). The APRI was calculated. ROC curve was used to evaluate the diagnostic value of each index for BA. Results　Values of body weight, GGT, TBA, DBIL, IBIL, AST, ALT and APRI were significantly higher in the BA group than those in the non-BA group (P＜0.05). ROC curve showed that GGT had the largest area under the curve (AUC) for BA diagnosis, which was 0.845 (95%CI: 0.801-0.890). When GGT was 264 U/L, its sensitivity and specificity were 0.732 and 0.814, respectively. The AUC of GGT+DBIL and GGT+APRI for BA were 0.880 (95%CI: 0.840-0.919) and 0.871 (95%CI: 0.830-0.912), respectively. Conclusion　GGT has better diagnostic value for BA, and GGT combined with DBIL and APRI has better diagnostic value than GGT alone.

Key words:  biliary atresia, gamma-glutamyltransferase, ROC curve, direct bilirubin, aspartate aminotransferase-to-platelet ratio index