中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2009年
12期
816-820
,共5页
莫晓冬%许兰平%刘开彦%刘代红%陈欢%王峰荣%张晓辉%韩伟%陈育红%黄晓军
莫曉鼕%許蘭平%劉開彥%劉代紅%陳歡%王峰榮%張曉輝%韓偉%陳育紅%黃曉軍
막효동%허란평%류개언%류대홍%진환%왕봉영%장효휘%한위%진육홍%황효군
造血干细胞移植%移植物抗宿主病%肝脏酶学
造血榦細胞移植%移植物抗宿主病%肝髒酶學
조혈간세포이식%이식물항숙주병%간장매학
Hematopoietic stem cell transplantation%Acute graft-versus-host disease%Liver enzymology
目的 探讨急性移植物抗宿主病(aGVHD)患者肝脏酶学变化与aGVHD严重程度的关系.方法 回顾性分析82例发生aGVHD的患者肝脏酶学的变化情况及与aGVHD严重程度的关系.结果 Ⅰ度aGVHD 15例(18.3%),Ⅱ度aGVHD 47例(57.3%),Ⅲ度aGVHD 13例(15.9%),Ⅳ度aGVHD 7例(8.5%);ALT升高49例(59.8%),AST升高36例(43.9%),碱性磷酸酶(ALP)升高8例(9.8%);其中34例(69.4%)患者ALT升高发生在aGVHD出现前,18例(50%)患者AST升高发生在aGVHD出现前,4例(50%)患者ALP升高发生在aGHVD出现前.ALT升高较AST升高提前出现;Ⅲ～Ⅳ度aGVHD组,ALT、AST升高的百分比(分别为80%和70%)明显高于Ⅰ～Ⅱ度aGVHD组(分别为53.2%和35.5%),但ALP升高的百分比无明显差异;Ⅲ～Ⅳ度aGVHD患者与Ⅰ～Ⅱ度aGVHD患者相比,ALT及AST峰值均明显升高;ALT升高组严重aGVHD的百分比明显升高.结论 肝酶学改变在aGVHD的发生中很常见,并且与aGVHD的严重程度明显相关,肝酶学尤其是ALT可能有助于早期预警严重aGVHD的发生.
目的 探討急性移植物抗宿主病(aGVHD)患者肝髒酶學變化與aGVHD嚴重程度的關繫.方法 迴顧性分析82例髮生aGVHD的患者肝髒酶學的變化情況及與aGVHD嚴重程度的關繫.結果 Ⅰ度aGVHD 15例(18.3%),Ⅱ度aGVHD 47例(57.3%),Ⅲ度aGVHD 13例(15.9%),Ⅳ度aGVHD 7例(8.5%);ALT升高49例(59.8%),AST升高36例(43.9%),堿性燐痠酶(ALP)升高8例(9.8%);其中34例(69.4%)患者ALT升高髮生在aGVHD齣現前,18例(50%)患者AST升高髮生在aGVHD齣現前,4例(50%)患者ALP升高髮生在aGHVD齣現前.ALT升高較AST升高提前齣現;Ⅲ～Ⅳ度aGVHD組,ALT、AST升高的百分比(分彆為80%和70%)明顯高于Ⅰ～Ⅱ度aGVHD組(分彆為53.2%和35.5%),但ALP升高的百分比無明顯差異;Ⅲ～Ⅳ度aGVHD患者與Ⅰ～Ⅱ度aGVHD患者相比,ALT及AST峰值均明顯升高;ALT升高組嚴重aGVHD的百分比明顯升高.結論 肝酶學改變在aGVHD的髮生中很常見,併且與aGVHD的嚴重程度明顯相關,肝酶學尤其是ALT可能有助于早期預警嚴重aGVHD的髮生.
목적 탐토급성이식물항숙주병(aGVHD)환자간장매학변화여aGVHD엄중정도적관계.방법 회고성분석82례발생aGVHD적환자간장매학적변화정황급여aGVHD엄중정도적관계.결과 Ⅰ도aGVHD 15례(18.3%),Ⅱ도aGVHD 47례(57.3%),Ⅲ도aGVHD 13례(15.9%),Ⅳ도aGVHD 7례(8.5%);ALT승고49례(59.8%),AST승고36례(43.9%),감성린산매(ALP)승고8례(9.8%);기중34례(69.4%)환자ALT승고발생재aGVHD출현전,18례(50%)환자AST승고발생재aGVHD출현전,4례(50%)환자ALP승고발생재aGHVD출현전.ALT승고교AST승고제전출현;Ⅲ～Ⅳ도aGVHD조,ALT、AST승고적백분비(분별위80%화70%)명현고우Ⅰ～Ⅱ도aGVHD조(분별위53.2%화35.5%),단ALP승고적백분비무명현차이;Ⅲ～Ⅳ도aGVHD환자여Ⅰ～Ⅱ도aGVHD환자상비,ALT급AST봉치균명현승고;ALT승고조엄중aGVHD적백분비명현승고.결론 간매학개변재aGVHD적발생중흔상견,병차여aGVHD적엄중정도명현상관,간매학우기시ALT가능유조우조기예경엄중aGVHD적발생.
Objective To investigate the correlation between the change of liver enzymes and the severity of acute graft-versus-host disease (aGVHD). Methods The liver enzyme and severity of aGVHD in 82 patients were analyzed retrospectively. Results Among the 82 aGVHD patients, 7 developed grade Ⅰ (18.3% ), 47 grade Ⅱ (57.3% ) ,13 grade Ⅰ (15.9% ) and 7 grade Ⅳ (8.5% ) aGVHD. The elevation of ALT, AST and ALP was found in 49(59. 8% ) , 36(43. 9% ) and 8(9. 8% ) patients respectively. Among these patients, 34(69.4% ) were ALT >40 U/L, 18(50% ) AST >40 U/L and 4 (50%) ALP > 132 U/ L before the onset of aGVHD. The elevation of ALT and AST was more common and the peak value was significantly higher in patients with grade Ⅲ-Ⅳ aGVHD than with grade Ⅰ-Ⅱ aGVHD, but those of ALP showed no difference between the two groups. Compared with the patients without ALT elevation, the proportion of severe aGVHD was higher in patients with ALT elevation. Conclusions The alteration of liver enzymology is common in aGVHD and its level is correlated with the severity of aGVHD. Liver enzymes, especially the ALT, may be used as a predictor of aGVHD.
