流行性出血热患者并发肝脏损害的临床观察

目的 探讨流行性出血热(EHF)病程中肝功能的变化及其临床意义.方法 对103例EHF患者的肝功能检测结果进行回顾性分析.结果 (1)重型及危重型患者肝脏的损害(ALT、SB及白蛋白)较轻型、中型患者有显著性差异;(2)死亡组肝脏的损害(ALT、SB)显著重于存活组(P值分别为0.000;0.000);(3)肝脏的损害(ALT)与患者的临床类型、年龄、血小板、白蛋白、乳酸脱氢酶及肌酐密切相关.结论 EHF患者并发肝脏损害较普遍,以轻、中度肝脏损害多见,而且与患者的临床类型、年龄、血小板、白蛋白、乳酸脱氢酶、肌酐及预后密切相关.病情愈重者,肝脏损害愈严重.因此在流行性出血热(EHF)病程中动态观察肝功能的变化,有助于判断病情和估计预后.

Clinical observation of liver damages in epidemic hemorrhagic fever

Objective To study the changes in liver function in patients with epidemic hemorrhagic fever (EHF). Method A retrospective analysis of the laboratory tests of liver function in 103 patients with EHF and control subjects was carried out. Results The alanine aminotransferase (ALT), serum bilirubin (SB) and albumin levels in patients with severe and critical liver damages significantly differed from those in milder cases, and more sever liver damages were found in the death cases of EHF than in survived patients in terms of ALT and SB increment (P=0.000). The liver damage was related to the clinical type, age and the levels of blood platelet , albumin, lactic dehydrogenase and creatinine in EHF cases (P=0.000, 0.000, 0.030, 0.010, 0.000 and 0.013, respectively). Conclusions Liver damage is common in patients with EHF and exacerbates with the severity of the disease. Monitoring of ALT, SB and albumin is helpful for evaluating the progression and prognosis of EHF.