一宗小儿暴发性伤寒肝功能酶学异常的临床分析

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目的 :对一宗小儿暴发性伤寒的肝功能酶学进行临床分析 ,以探讨小儿伤寒性肝炎的临床特点。方法 :对发生于 2 0 0 2年 9月~ 10月本市一所小学伤寒感染的 78例儿童进行临床分析 ,并与成人伤寒进行对照。结果 :儿童共发生肝功能损害 46例 ,占5 8 9%,肝功损害者均有酶学升高 ,ALT、AST明显高于成人组 (均P <0 0 5 ) ,肝损害与发热热程呈正相关 ,随热程延长 ,肝功能酶学逐步升高 ,不同热程间酶学改变差异有显著性 (P <0 0 0 1)。结论 :小儿伤寒肝损害临床表现不典型 ,以血清酶学改变为主 ,并与临床病情的发展相一致 ,与发热呈正相关 ,随热程的延长 ,酶学升高也越明显 ,热退后肝功能逐步恢复 ,预后较好 Objective: To analyze the clinical features of liver function enzyme in a pediatric case of typhoid fever to discuss the clinical features of pediatric typhoid hepatitis. Methods: A total of 78 children with typhoid fever in a primary school in the city from September to October in 2002 were analyzed and compared with that of adult typhoid fever. Results: There were 46 cases of liver dysfunction in children, accounting for 58.9%. Enzymes of liver damage were increased, ALT and AST were significantly higher in children than in adults (all P <0.05), liver damage and fever Cheng was positively correlated, with the extension of the heat stroke, liver function gradually increased enzymatic enzymes, enzymatic changes between different thermal differences was significant (P <0 0 0 1). Conclusions: The clinical manifestations of typhoid fever and liver damage in children are not typical, with the changes of serum enzymology, which are consistent with the development of clinical conditions and have a positive correlation with fever. With the prolongation of heat stroke, the enzyme increases more obviously, Liver function gradually restored, the prognosis is good
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