论文部分内容阅读
疸酶分离是重症病毒性肝炎预后不良的一项重要指标。我科收治的病例中有9例发生疸酶分离现象;6例死亡,3例存活。本组6例死亡者的肝脏均见缩小,有4例出现腹水,3例发生消化道出血,4例出现少尿及无尿,2例有明显中毒性膨肠,3例发生肝性脑病。这种疸酶分离现象是由于肝细胞广泛坏死,几乎完全丧失胆红质的代谢功能,血中结合型胆红质迅速上升;因肝细胞广泛坏死无更多的酶合成释放入血,故谷-丙转氨酶逐渐下降;凝血酶原时间明显延长,其活动度明显下降;血中枝链氨基酸/芳香族氨基酸的比值明显下降,甲硫氨基酸浓度也明显上升。 存活3例的肝脏均无缩小,且有逐渐增大者2例。仅1例出现腹水,余2例均未出现其
Bile enzyme separation is an important indicator of poor prognosis of severe viral hepatitis. Nine cases were treated in our department occurred in the separation of jaundice enzyme; 6 died, 3 survived. The group of 6 deaths were reduced to liver, ascites in 4 cases, gastroesophageal bleeding in 3 cases, oliguria and anuria in 4 cases, toxic swelling in 2 cases and hepatic encephalopathy in 3 cases. This phenomenon of bile enzyme separation is due to extensive necrosis of liver cells, almost completely lose the metabolism of bilirubin, blood bilirubin rapidly rose; due to extensive necrosis of liver cells no more enzyme synthesis release into the blood, so Valley - aminotransferase gradually decreased; prothrombin time was significantly prolonged, and its activity decreased significantly; blood branched chain amino acid / aromatic amino acid ratio decreased significantly, methionine amino acid concentration also increased significantly. The survival of 3 cases of the liver were no reduction, and gradually increased in 2 cases. Only 1 case of ascites, more than 2 cases did not appear