中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
15期
139-140
,共2页
肝功能%高胆红素血症%败血症%脓毒症
肝功能%高膽紅素血癥%敗血癥%膿毒癥
간공능%고담홍소혈증%패혈증%농독증
Liver functions%Hyperbilirubinemia%Septicaemia%Sepsis
目的:探讨肝功能对败血症诊断的价值.方法:选择2010年2月-2012年4月住本院重症医学科的脓毒症患者,动态监测入选患者的血培养及肝功能,根据按败血症诊断标准回顾性将患者分为败血症组和非败血症组,分析各肝功能指标在两组中的变化特点及对败血症的诊断意义.结果:败血症组肝功能早期常见γ-谷氨酰转肽酶(γ-GGT)、碱性磷酸酶(ALP)、谷草转氨酶(AST)中1~3项升高.对比两组的第一次肝功能结果,败血症组的γ-GGT、ALP、AST显著高于非败血症组(P<0.01),其中γ-GGT升高对诊断败血症的诊断价值最高,以61.5μmmol/L为截断值,诊断败血症的灵敏度为87.5%,特异度为97.6%.21例γ-GGT升高,γ-GGT阳性时间早于败血症血病原菌培养阳性时间3~9 d.败血症组高胆红素血症发生率为33.3%,显著高于非败血症组(9.5%).结论:γ-GGT升高可作为败血症的早期筛查指标,特定的肝功能变化特点可能作为败血症临床诊断的依据之一.
目的:探討肝功能對敗血癥診斷的價值.方法:選擇2010年2月-2012年4月住本院重癥醫學科的膿毒癥患者,動態鑑測入選患者的血培養及肝功能,根據按敗血癥診斷標準迴顧性將患者分為敗血癥組和非敗血癥組,分析各肝功能指標在兩組中的變化特點及對敗血癥的診斷意義.結果:敗血癥組肝功能早期常見γ-穀氨酰轉肽酶(γ-GGT)、堿性燐痠酶(ALP)、穀草轉氨酶(AST)中1~3項升高.對比兩組的第一次肝功能結果,敗血癥組的γ-GGT、ALP、AST顯著高于非敗血癥組(P<0.01),其中γ-GGT升高對診斷敗血癥的診斷價值最高,以61.5μmmol/L為截斷值,診斷敗血癥的靈敏度為87.5%,特異度為97.6%.21例γ-GGT升高,γ-GGT暘性時間早于敗血癥血病原菌培養暘性時間3~9 d.敗血癥組高膽紅素血癥髮生率為33.3%,顯著高于非敗血癥組(9.5%).結論:γ-GGT升高可作為敗血癥的早期篩查指標,特定的肝功能變化特點可能作為敗血癥臨床診斷的依據之一.
목적:탐토간공능대패혈증진단적개치.방법:선택2010년2월-2012년4월주본원중증의학과적농독증환자,동태감측입선환자적혈배양급간공능,근거안패혈증진단표준회고성장환자분위패혈증조화비패혈증조,분석각간공능지표재량조중적변화특점급대패혈증적진단의의.결과:패혈증조간공능조기상견γ-곡안선전태매(γ-GGT)、감성린산매(ALP)、곡초전안매(AST)중1~3항승고.대비량조적제일차간공능결과,패혈증조적γ-GGT、ALP、AST현저고우비패혈증조(P<0.01),기중γ-GGT승고대진단패혈증적진단개치최고,이61.5μmmol/L위절단치,진단패혈증적령민도위87.5%,특이도위97.6%.21례γ-GGT승고,γ-GGT양성시간조우패혈증혈병원균배양양성시간3~9 d.패혈증조고담홍소혈증발생솔위33.3%,현저고우비패혈증조(9.5%).결론:γ-GGT승고가작위패혈증적조기사사지표,특정적간공능변화특점가능작위패혈증림상진단적의거지일.
Objective:To evaluate liver function tests as potential indicators of septicaemia. Method:Study was conducted between February 2010 and April 2012,included patients on admission ICU who suffered from sepsis,to dynamic monitor the blood cultures and liver function of the selected patients. According to the diagnostic criteria retrospectively the patients were divided into septicaemia group and non-septicaemia group. To analyze the indexes of liver function of the two groups,summarize the diagnostic role of liver function in septicaemia. Result:The serum levels of gamma-glutamyl,transpeptidase(γ-GGT),alkaline phosphatase(ALP),aspartate aminotransferase(AST)were in 1 to 3 increase universally at the early stage in septicaemia group. To compare the first liver function results of the two groups,serum levels of γ-GGT,ALP,AST of septicaemia group were significantly higher than those in non-septicaemia(P<0.01). Elevatedγ-GGT levels in the diagnosis of septicaemia diagnostic value was the highest,with 61.5μmmol/L cutoff value of the diagnosis of septicaemia,the sensitivity and specificity was 87.5%and 97.6%respectively. Twenty-one of the 24 patients with elevatedγ-GGT levels had an increase in serumγ-GGT 3 to 9 days before their initial positive blood culture. The incidence of hyperbilirubinemia in septicaemia group was 33.3%,which was significantly higher than that in non-septicaemia(9.5%). Conclusion:Elevatedγ-GGT level can be served as a early indicator of screening septicemia.Specific features of liver function may be a clinical diagnosis of septicaemia.
