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目的探讨轮状病毒肠炎合并肝脏损害的临床特征。方法对485例轮状病毒肠炎患儿作肝功能及肝脏B超检查,并对其中108例合并肝脏损害者的临床特征进行分析。结果(1)108例轮状病毒肠炎合并肝脏损害患儿中,单纯丙氨酸转移酶(ALT)升高者30例,占27.8%,单纯天冬氨酸转移酶(AST)升高者18例,占16.7%,单纯γ-谷氨酰转肽酶(γ-GT)升高者10例,占9.3%,ALT和AST2项酶同时升高者24例,占22.3%,ALT、AST和γ-GT3项酶同时升高者12例,占11.1%,转氨酶升高伴胆红素(TBIL或DBIL)升高者3例,占2.7%,转氨酶升高伴白蛋白(ALB)降低者3例,占2·7%,肝功能异常伴肝脏肿大者8例,占7.4%;ALT升高总例数为66例,占61.1%,AST升高总例数为54例,占50%,γ-GT升高总例数为22例,占20.4%。(2)经病毒唑及能量合剂等护肝治疗后,2周内ALT恢复正常者60例,占全部ALT升高病例的90.9%,AST恢复正常者51例,占全部ALT升高病例的94.4%,γ-GT恢复正常者21例,占全部γ-GT升高病例的95.5%;合并TBIL或DBIL升高及ALB降低、肝脏肿大者,均于2周内全部恢复正常。结论轮状病毒肠炎可同时合并肝脏损害,其中,以ALT及AST升高者最多见,经一般抗病毒及护肝等治疗后,预后良好,绝大多数患儿在2周内肝功能及肝脏大小均可恢复正常。
Objective To investigate the clinical features of rotavirus enteritis complicated with liver damage. Methods 485 cases of rotavirus enteritis in children with liver function and liver B ultrasound examination, and 108 cases of liver damage in patients with clinical features were analyzed. Results (1) Among the 108 cases of rotavirus enteritis complicated with liver damage, 30 cases were elevated alanine aminotransferase (ALT), accounting for 27.8%, and those with aspartate aminotransferase (AST) only 18 10 cases (9.3%) had elevated γ-glutamyl transpeptidase (γ-GT) alone, 24 cases (22.3%) had ALT and AST2 elevated simultaneously, ALT, AST and γ-GT3 increased simultaneously in 12 cases, accounting for 11.1%, elevated transaminases with elevated bilirubin (TBIL or DBIL) in 3 cases, accounting for 2.7%, elevated transaminases with decreased albumin (ALB) 3 Cases accounted for 2.7%, liver dysfunction with liver enlargement in 8 cases, accounting for 7.4%; ALT increased the total number of cases was 66 cases, accounting for 61.1%, AST increased the total number of cases was 54 cases, accounting for 50% , the total number of cases of γ-GT increased in 22 cases, accounting for 20.4%. (2) 60 cases of ALT returned to normal within 2 weeks after treatment with ribavirin and energy mixture, accounting for 90.9% of all cases with elevated ALT, 51 cases of normal AST recovery, 94.4% of all cases with elevated ALT %, γ-GT returned to normal in 21 cases, accounting for 95.5% of all patients with elevated γ-GT; combined TBIL or DBIL increased and ALB decreased, enlarged liver, were all returned to normal within 2 weeks. Conclusions Rotavirus enteritis may be associated with liver damage. Among them, ALT and AST are the most common. After general antiviral therapy and hepatoprotective therapy, the prognosis is good. Most children have liver function and liver function within 2 weeks Size can be restored to normal.