CAJ | 학술논문

目的探讨成人获得性风疹患者肝功能损害的临床及病理学特点,为临床诊治及判断预后提供依据.方法 36例成人获得性风疹患者,分别于入院次日及以后每隔5～10 d抽取静脉血,全自动生化分析仪定量检测患者血清总胆红素、直接胆红素、ALT、AST、血清总蛋白和血清白蛋白等肝功能指标,对其并发肝功能损害情况进行了连续动态观察,并对其中2例典型病例进行了肝活组织病理检查.无肝功能损害患者与并发肝功能损害患者住院天数比较采用秩和检验.结果成人获得性风疹患者并发肝功能损害发生率高达77.8%,但其肝功能损害多轻微,多以ALT和(或)AST升高为主,其中以退疹后的第6～10日肝功能损害发生率最高,达72.2%,且此时肝功能损害亦最明显.肝脏活组织病理学检查发现其肝脏组织结构完整,仅有肝脏组织轻微炎症改变,并发现其病毒包涵体.并发肝功能损害患者组平均住院18.2 d,与无并发肝功能损害患者组平均住院7.8 d比较,差异有统计学意义(u=3.596,P＜0.05).结论近年成人获得性风疹患者并发肝功能损害发生率高,但其肝功能损害多轻微,多以ALT升高为主.但一旦出现AST异常或黄疸,说明肝功能损害较重,除积极治疗外,要严密观察,防止发生急性肝衰竭.如本病患者并发肝功能损害,则明显延长了病程及住院时间.
목적 탐토성인획득성풍진환자간공능손해적림상급병이학특점,위림상진치급판단예후제공의거.방법 36례성인획득성풍진환자,분별우입원차일급이후매격5～10 d추취정맥혈,전자동생화분석의정량검측환자혈청총담홍소、직접담홍소、ALT、AST、혈청총단백화혈청백단백등간공능지표,대기병발간공능손해정황진행료련속동태관찰,병대기중2례전형병례진행료간활조직병리검사.무간공능손해환자여병발간공능손해환자주원천수비교채용질화검험.결과 성인획득성풍진환자병발간공능손해발생솔고체77.8%,단기간공능손해다경미,다이ALT화(혹)AST승고위주,기중이퇴진후적제6～10일간공능손해발생솔최고,체72.2%,차차시간공능손해역최명현.간장활조직병이학검사발현기간장조직결구완정,부유간장조직경미염증개변,병발현기병독포함체.병발간공능손해환자조평균주원18.2 d,여무병발간공능손해환자조평균주원7.8 d비교,차이유통계학의의(u=3.596,P＜0.05).결론 근년성인획득성풍진환자병발간공능손해발생솔고,단기간공능손해다경미,다이ALT승고위주.단일단출현AST이상혹황달,설명간공능손해교중,제적겁치료외,요엄밀관찰,방지발생급성간쇠갈.여본병환자병발간공능손해,칙명현연장료병정급주원시간.
Objective To explore the clinical and pathological features ofliver injury in adults with acquired rubella. Methods Thirty-six adult patients with acquired rubella (AAR) were enrolled in this study,the liver functions were dynamically analyzed, liver biopsy was done in two patients. Results Liver injury was found in 77.8% of the 36 patients, with slight elevation of ALT and/or AST. The highest incidence and the most serious liver injury occurred in the period of 6-10d after vanishing of the rashes. Viral inclusion bodies were found in the liver specimen, with complete histological architecture but slight inflammation. The mean hospitalization days of AAR accompanied with liver injury and without liver injury were 18.2days, 7.8days,respectively (u = 3.596 ＞1.96, P ＜ 0.05). Conclusion High incidence of liver injury is observed in the adult patients with acquired rubella occurred in recent years, usually exhibited by mild liver injury with slight elevation of ALT. The elevation of AST or jaundice may indicate more serious liver injury, and these patients should be given active treatment to prevent acute liver failure. Liver injury may prolong the course of rubella patients.