摘要
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1～3d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1～5d，平均（3．35±0．89）d。ALT869～4354U／L，AST773-4833U／L，LDH1021～2662U／L。总胆红素升高16例，总胆红素14～54pcmol／L。AST恢复正常上限2倍以内时间为9～16d，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。
Objective To investigate the incidence, influencing factors and clinical features of isehemic 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±354 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 vmol/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 oatients with ischemic heoatitis.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第11期1189-1191,共3页
Chinese Journal of Geriatrics
关键词
肝疾病
缺血
Liver Diseases
Ischemia
