摘要
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3～9d。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。
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 septieaemia 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.O1 ） . Elevated γ-GGT levels in the diagnosis of septicaemia diagnostic value was the highest, with 61.5 μmmol/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 elevated γ-GGT levels had an increase in serum T -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： Elevated γ- GGT level can be served as a early indicator of screening septicemia.Specific features of liver function may be a clinical diagnosis of septicaemia.
出处
《中国医学创新》
CAS
2013年第15期139-141,共3页
Medical Innovation of China
关键词
肝功能
高胆红素血症
败血症
脓毒症
Liver functions
Hyperbilirubinemia
Septicaemia
Sepsis
