稀释后测定ALT、AST值的临床意义

目的：探讨用全自动分析仪测定ALT、AST结果与实际不符的原因和解决办法。方法：迈瑞300全自动分析仪速率法检测ALT、AST。结果：有一些ALT、AST测定值太低甚至为零，经过稀释后其结果与稀释前相差很大。结论：遇到过低的结果寻找原因，查看曲线避免报告结果与临床不符。     

产前不同监测方法对ICP胎儿监测的临床意义

目的:探讨妊娠期肝内胆汁淤积症(ICP)的产前监测方法。方法:对我院同期的ICP患者与正常孕妇60例进行肝功能、S/D值(脐动脉收缩期最大血流速/舒张末期最低血流速)、Manning评分、无应激试验(NST)及羊水污染、Apgar评分、胎儿体重进行对比分析;通过χ2检验分析Manning评分各项监测指标中对ICP有意义的项目;利用多元回归分析的方法了解不同产前监测方法与ICP新生儿Apgar评分的关系。结果:ICP患者与正常孕妇在肝功能指标、S/D值、Manning评分及羊水污染率、Apgar评分间的差异有统计学意义;在Manning评分各项监测指标中对ICP的监测有意义的指标是胎动和肌张力;产前监测ICP患者的转氨酶及NST水平变化可预测ICP患者新生儿的Apgar评分,而胆红素、胆汁酸、甘胆酸、S/D值、Manning评分的变化与ICP患者新生儿的Apgar评分的变化无相关性。结论:ICP患者Manning评分的监测指标中胎动和肌张力的变化对胎儿宫内情况有监测意义;在对ICP患者的各种产前监测方法中,转氨酶水平及NST评分的监测能够反应新生儿出生状态。     

住院患儿转氨酶升高的回顾性分析

目前在临床上药物性损伤已非常普遍。现对1242例住院患儿（非肝病科患儿）和953例健康儿童的谷丙特氨酶和谷草特氨酶进行了回顾性对比统计，发现住院患儿的谷丙特氨酶和谷草转氨酶大于40IU／L以上的所占比例分别为26．08％和31％。而健康儿童的谷丙特氨酶和谷草特氨酶大于40IU／L以上的所占比例分别为3．99％和3．16％。因此，在住院患儿和健康儿童中存在着显著性差异。     

脂肪肝的超声诊断与丙氨酸转氨酶活性、血脂浓度的相关分析

目的:探讨脂肪肝的超声诊断及脂肪肝与丙氨酸转氨酶(ALT)活性和甘油三酯(TG)、总胆固醇(TC)浓度的关系.方法:对我院2005年8月～2006年3月门诊健康体检1122名受检人员中的脂肪肝360例和正常对照组762例进行ALT活性和甘油三酯、总胆固醇浓度测定,并对结果进行分析.结果:脂肪肝患者血清ALT活性、甘油三酯、总胆固醇浓度均显著高于对照组(P＜0.05),并且脂肪肝的程度越重,ALT异常的可能性越大(P＜0.05),血脂异常的可能性也越大(P＜0.05).结论:脂肪肝与ALT活性和血脂浓度有关.此外,超声对脂肪肝患者的诊断有较高的临床实用价值.     

人参皂苷CK对四氯化碳致大鼠慢性肝损伤的影响

目的研究人参皂苷CK对CC l4致慢性肝损伤的影响。方法用CC l4致大鼠慢性肝损伤模型,观察人参皂苷CK(0.3,1,3 mg/kg)对大鼠血清天冬氨酸转氨酶(aspartate transam inase,ALT)、丙氨酸转氨酶(alan ine transam inase,AST)、超氧化物歧化酶(superoxide d ismutase,SOD)、丙二醛(m alond ialdehyde,MDA)及透明质酸(hyaluron ic ac id,HA)、Ⅲ型前胶原(pre-collagenⅢ,PCⅢ)的影响,并对肝脏组织进行病理学观察。结果人参皂苷CK小剂量(0.3 mg/kg)能降低血清转氨酶ALT,AST水平,增加血清SOD的含量,降低MDA含量;CK中、高剂量无明显作用。CK各剂量组血清HA、PCⅢ和肝组织病理未见明显改变。结论CK低剂量对CC l4致慢性肝损伤具有一定的保护作用,其作用可能与抗氧化有关。     

8181名体检者中HBV血清学标志物与ALT的检测分析

目的:了解东莞市体检人群中乙肝病毒(HBV)感染情况与血清丙氨酸氨基转移酶(ALT)的异常率。方法:对8181名体检者应用酶联免疫吸附法(ELISA)法测定HBsAg、HBsAb、HBeAg、HBeAb、HBcAb,用速率法测定ALT。结果:HBsAg的阳性率为13.14%,HBeAg的阳性率为4.89%,ALT的异常率为3.40%。乙型肝炎病毒血清学标志物主要以HBsAg、抗-HBe、抗-HBc阳性和HBsAg、HBeAg、抗-HBc阳性的两种模式为主。结论:东莞市体检者中的HBsAg的阳性率高于全国的HBsAg的阳性率,其中HBsAg阳性率20岁以下相对低些,20岁~30岁的高达17.19%,HBeAg的阳性率在20岁~30岁的打工者中占较大比例。其人群分布与计划免疫、文化程度、卫生习惯、生活环境等因素有关。     

Hearing impairment and hypoxia ischaemic encephalopathy: Incidence and associated factors

Objective

To establish the local incidence of hearing loss in newborns with Hypoxic Ischaemic Encephalopathy (HIE) and to identify associated risk factors.

Metabolic, hormonal, oxidative, and inflammatory factors in pediatric obesity-related liver disease

OBJECTIVE: To examine the role of metabolic, hormonal, oxidative, and inflammatory factors in pediatric obesity-related liver disease. STUDY DESIGN: In 50 obese children (age 7 to 14 years) with (n = 20, group 1) or without (n = 30, group 2) hypertransaminasemia and ultrasonographic liver brightness, we studied insulin resistance (fasting glucose/insulin ratio [FGIR]) and serum levels of leptin, iron, transferrin, ferritin, C-reactive protein (CRP), white blood cell (WBC) count, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, C282Y and H63D mutations, and erythrocytic glutathione peroxidase (GPX) activity. RESULTS: FGIR (6.7 +/- 4.1 vs 9.2 +/- 5.2; P = .02), serum ferritin (88.8 +/- 36.0 vs 39.9 +/- 24.0 ng/mL; P = .0001), serum CRP (5.4 +/- 6.0 vs 1.1 +/- 1.6 mg/dL; P = 0.004), and GPX (8.4 +/- 0.9 vs 5.0 +/- 0.5 U/g Hb; P = .05) were significantly higher and more frequently deranged in group 1 than in group 2. FGIR, ferritin, and CRP values were simultaneously deranged in 41% of the group 1 patients and in none of the group 2 patients ( P = .098). Serum leptin, iron, and transferrin, WBC, TNF-alpha, IL-6, and C282Y and H63D mutations were similar in the 2 groups. CONCLUSIONS: Insulin resistance, oxidative stress, and low-grade systemic inflammatory status are implicated in pediatric obesity-related liver disease. These findings may be useful in planning pathophysiologically based therapeutic trials for hepatopathic obese children who are unable to follow hypocaloric diets.     

Liver volume in thalassaemia major: relationship with body weight,serum ferritin,and liver function

Background: It is not known whether body weight alone can adjust for the volume of liver in the calculation of the chelating dose in -thalassaemia major patients, who frequently have iron overload and hepatitis. Objective: The hypothesis is that liver volume in children and adolescents suffering from -thalassaemia major is affected by ferritin level and liver function. Materials and methods: Thirty-five -thalassaemia major patients aged 7–18 years and 35 age- and sex-matched controls had liver volume measured by MRI. Serum alanine aminotransferase (ALT) and ferritin levels were obtained in the thalassaemia major patients. Results: Body weight explained 65 and 86% of the change in liver volume in -thalassaemia major patients and age-matched control subjects, respectively. Liver volume/kilogram body weight was significantly higher (P<0.001) in thalassaemia major patients than in control subjects. There was a significant correlation between ALT level and liver volume/kilogram body weight (r=0.55, P=0.001). Patients with elevated ALT had significantly higher liver volume/kilogram body weight (mean 42.9±12 cm³/kg) than control subjects (mean 23.4±3.6 cm³/kg) and patients with normal ALT levels (mean 27.4±3.6 cm³/kg).Conclusions: Body weight is the most important single factor for liver-volume changes in thalassaemia major patients, but elevated ALT also has a significant role. Direct liver volume measurement for chelation dose adjustment may be advantageous in patients with elevated ALT.     

Inherited factor VII deficiency: identification of two novel mutations (A191V and T239P) in the catalytic domain

We describe here five F7 mutations found in four patients without bleeding history, despite constitutional coagulation Factor VII (FVII) deficiency. All five mutations are missense and affect the catalytic domain of FVII (A191T, A191V, T239P, R224Q and M298I). The A191V and T239P mutations are novel and were found in homozygous patients with no clinical bleeding tendency. The patient diagnosed with the A191V mutation had a phenotype corresponding to a moderate type 1 FVII deficiency (FVII:C 4%, FVII:Ag 5%). The T239P mutation was found in a patient with mild type 2 FVII deficiency (FVII:C 25%, FVII:Ag 95%). Novel mutations are both in close vicinity to the charge-stabilizing system of FVII. Modeling studies allow understanding in part the molecular basis for the loss of function.