108例小儿轮状病毒肠炎合并肝脏损害临床分析  

The clinical analysis of 108 cases of rotavirus enteritis united with hepatic lesion

作　　者：刘纯义[1] 孙毅[1] 郎新玲[1] 张侃[1] 刘亚秋[1] 郭丽华[1] 

机构地区：[1]广东省深圳市宝安区妇幼保健院儿科,518133

出　　处：《中国妇幼保健》2006年第1期52-53,共2页Maternal and Child Health Care of China

摘　　要：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Υ-谷氨酰转肽酶(Υ-G T)升高者10例,占9.3%;ALT和AST同时升高者24例,占22.3%;ALT、AST和Υ-G T同时升高者12例,占11.1%;转氨酶升高伴胆红素(TB IL或DB IL)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%;Υ-G T升高总例数为22例,占20.4%。(2)经病毒唑及能量合剂等治疗后,2周内ALT恢复正常者60例,占全部AST升高病例的90.9%;AST恢复正常者51例,占全部AST升高病例的94.4%;Υ-G T恢复正常者21例,占全部Υ-G T升高病例的95.5%;合并TB IL或DB IL升高及ALB降低、肝脏肿大者,全部于2周内恢复正常。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可恢复正常。Objective： To investigate the clinical features of rotavirus enteritis combined with hepatic lesion. Methods： Hepatic function and B type ultrasonic wave inspection were carried out among 485 cases of rotavirus enteritis and clinical features of 108 cases united with hepatic lesion were analyzed. Results： （1） Among 108 cases of rotavirus enteritis united with hepatic lesion, 30 cases with increased ALT accounted for 27.8% and 18 cases with increased AST （ 16. 7% ） ; 10 cases with increased γ - GT 9. 3% ; 24 cases with increased ALT and AST 22. 3% ; 12 cases with increased ALT, AST and γ - GT 11.1% ; 3 cases with increased transaminase and cholochrome （ TBIL or DBIL ） 2.7% ; 3 cases with increased transaminase followed decreased ALB （2. 7% ） ; 8 cases with hepatic dysfunction and tumefaction 7.4% ; 66 cases with increased ALT 61.1% ; 54 cases with increased AST 50 % ; 21 cases with increased γ - GT 20. 4%.. （ 2 ） Therapeutics by virazole and energy mistura two weeks later, ALT returned to normal in 60 cases （ 90. 9% ） ; AST returned to normal in 51 cases （94. 4% ） ; γ - GT returned to normal in 21 cases （ 95.5% ） ; Cases with increased TBIL or DBIL and decreased ALB, hepatic tumefaction recovered within 2 weeks. Conclusion： The cases of rotavirus enteritis maybe combine with hepatic lesion, increase in ALT and AST are most frequently observed. The prognosis is fairly good after antivirus and protecting hepatic therapy , most of the sick children could recover from hepatic function lesion and hepatic tumefaction within 2 weeks.

关 键 词：轮状病毒 肠炎 肝脏 损害 

分 类 号：R725.7[医药卫生—儿科]