43例急性四氯化碳中毒性肝病患者临床及胃镜下表现  

Clinical and endoscopic manifestations of patients with carbon tetrachloride-induced acute toxic liver injury:analysis of 43 cases

作　　者：朱伟[1] 孔玉林 刘杰[2] 

机构地区：[1]江苏省苏州市第五人民医院感染病科,215007 [2]江苏省苏州市第五人民医院职业病科,215007

出　　处：《实用肝脏病杂志》2013年第6期530-531,共2页Journal of Practical Hepatology

摘　　要：目的观察急性四氯化碳中毒性肝病患者临床及胃镜下表现。方法回顾性分析43例急性四氯化碳中毒性肝病患者临床表现和肝功能变化情况,其中28例因显著消化道表现而行胃镜检查。结果 43例急性四氯化碳中毒性肝病患者临床主要表现为乏力、恶心、呕吐和腹痛等消化道症状,伴黄疸和头晕;血清总胆红素为(16.5±13.4)μmol/L,丙氨酸氨基转移酶为(273±171)U/L,甘油三酯为(1.31±0.74)mmol/L,前白蛋白为(224±64)mg/L;28例患者胃镜下表现为轻度至重度浅表性胃炎,未见溃疡。其中糜烂明显6例,胆汁反流9例,食道霉菌5例(17.9%)。病理学检查示轻度浅表性胃炎14例,中度6例,重度8例;5例患者HP阳性,11例表现为粘膜下出血;患者平均住院时间为36天。结论急性四氯化碳中毒性肝病患者肝脏损害程度似较轻,但恢复较慢,消化道症状重,多伴有浅表性胃炎表现。Objective To observe the clinical and endoscopic manifestation of patients with carbon tetra-chloride-induced acute toxic liver injury. Methods The clinical manifestations and liver functions in 43 patients with carbon tetrachloride-induced acute liver toxic injury were analyzed retrospectively. Endoscopic features in 28 patients out of them underwent gastroduodenal endoscopy for remarkable upper gastrointestinal symptoms were also obtained. Results The main gastrointestinal symptoms were fatigue,nausea,vomiting and abdominal pain in this series;The total serum bilirubin was（16.5±13.4）μmol/L,alanine aminotransferase（273±171）U/L,triglyceride（1.31±0.74）mmol/L,and prealbumin （224±64）mg/L;Gastroduodenal endoscopy showed mild to severe superficial gastritis and no ulcer was identified. Erosion of mucosa was apparent in six cases,bile reflux in nine cases and esophageal fungus in 5 cases（17.9%）. Pathological examination showed mild superficial gastritis in 14 cases,mod-erate gastritis in 6 cases and severe gastritis in 8 cases;Five cases were found with HP positive and 11 cases with submucosal hemorrhage;The average hospitalization was 36 days. Conclusion Carbon tetrachloride-induced acute toxic liver injury presents with a seemly mild liver damage and a probably long recovery time. The gas-trointestinal symptoms may be apparent,with markedly mucosa erosion and submucosal bleeding.

关 键 词：中毒性肝病 四氯化碳 急性中毒 胃炎 

分 类 号：R575.1[医药卫生—消化系统]