CAJ | 학술논문

目的探讨缺血性肝炎的发生率、影响因素及临床特征. 方法观察我院收治的各种休克、呼吸衰竭等重症患者转氨酶、乳酸脱氢酶变化,总结缺血性肝炎发生率,总结其临床资料及影响因素. 结果观察重症患者317例,发生缺血性肝炎53例,70岁以上老年人、男性发病率高.患者于休克、呼吸衰竭后1～3 d内出现丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)明显增高,高峰出现时间1～5 d,平均(3.35±0.89)d.ALT 869～4354 U/L,AST773～4833 U/L,LDH 1021～2662 U/L.总胆红素升高16例,总胆红素14～54 μmol/L.AST恢复正常上限2倍以内时间为9～16 d,平均(13.0±1.6)d.转氨酶升高程度与性别、年龄及有无基础肝病无关,酶学变化时间与性别无关.年龄≥70岁的患者AST峰值出现晚,恢复时间长于年龄＜70岁的患者,差异有统计学意义(P＜0.01).有基础肝病的患者AST达高峰时间明显早于无肝病者,AST恢复时间略长于后者,差异有统计学意义. 结论缺血性肝炎男性、老年人多发高龄、患有基础肝病可影响缺血性肝炎患者转氨酶恢复时间.
목적 탐토결혈성간염적발생솔、영향인소급림상특정. 방법 관찰아원수치적각충휴극、호흡쇠갈등중증환자전안매、유산탈경매변화,총결결혈성간염발생솔,총결기림상자료급영향인소. 결과 관찰중증환자317례,발생결혈성간염53례,70세이상노년인、남성발병솔고.환자우휴극、호흡쇠갈후1～3 d내출현병안산안기전이매(ALT)、천문동안산안기전이매(AST)、유산탈경매(LDH)명현증고,고봉출현시간1～5 d,평균(3.35±0.89)d.ALT 869～4354 U/L,AST773～4833 U/L,LDH 1021～2662 U/L.총담홍소승고16례,총담홍소14～54 μmol/L.AST회복정상상한2배이내시간위9～16 d,평균(13.0±1.6)d.전안매승고정도여성별、년령급유무기출간병무관,매학변화시간여성별무관.년령≥70세적환자AST봉치출현만,회복시간장우년령＜70세적환자,차이유통계학의의(P＜0.01).유기출간병적환자AST체고봉시간명현조우무간병자,AST회복시간략장우후자,차이유통계학의의. 결론 결혈성간염남성、노년인다발고령、환유기출간병가영향결혈성간염환자전안매회복시간.
Objective To investigate the incidence,influencing factors and clinical features of ischemic hepatitis.Methods Changes of serum transaminase and lactate dehydrogenase in patients with shock and respiratory failure were recorded in our hospital.Ischemic hepatitis was identified according to diagnosis guidelines,and its incidence was counted.Clinical data of patients with ischemic hepatitis were recorded.Results There were 53 cases diagnosed as ischemic hepatitis in 317 severe patients,including hemorrhagic shock,heart failure,respiratory failure,et al.The incidence was high in elderly patients aged over 70 years and male.Levels of alanine aminotransferase (ALT),AST and lactic dehydrogenase (LDH) were significantly increased 1-3 days after shock and respiratory failure,then reached to peak value 1-5 days [averaged (3.35±0.89) days] after shock and respiratory failure.Serum ALT was 869-4354 U/L,AST was 773-4833U/L and LDH was 1021-2662 U/L.Total bilirubin level was increased in 16 cases and the total bilirubin was 14-54 μmol/L.AST was declined to a point within 2 times the upper limit of normal range after 9-16 days,averaged (13± 1.6) days.Elevated transaminase level had no correlation with sex,age and pre-existing liver diseases.The time of enzyme changes had no correlation with sex but age and liver diseases.Patients aged ≥ 70 years had later AST peak and the recovery time was longer than younger patients (P＜0.01).Conclusions Ischemic hepatitis occurs mainly in men and elderly people.But advanced age and underlying liver diseases can affect the recovery time of transaminase in patients with ischemic hepatitis.