登革热并发肝损害的临床特征  

The clinical characteristics of dengue fever complicated with liver damage

作　　者：罗纯[1] 艾香英[1] 范慧敏[1] 谢敏[1] 刘领弟[1] 谭行华[1] 

机构地区：[1]广州市第八人民医院,广东广州510060

出　　处：《热带医学杂志》2015年第11期1499-1501,共3页Journal of Tropical Medicine

基　　金：国家"十二五"科技重大专项(2012ZX10004301-003)

摘　　要：目的探讨登革热并发肝损害的临床特征。方法收集2014年广州市第八人民医院收治的343例登革热患者的临床资料,对其进行回顾性分析。结果 343例登革热患者中,排除病毒性肝炎、脂肪肝、酒精肝、药物性肝损害及溶血等其他原因可能引起的肝功能损伤者,共293例。登革热病例显示肝脏损害发生率较高,ALT异常占76.03%,AST异常占88.40%,该组患者ALT、AST达到峰值的病程天数分别为(8.59±2.56)d、(7.5±2.24)d。年龄小于20岁登革热患者占4.5%,20岁至40岁之间登革热患者占26.4%,40岁至60岁之间登革热患者占28.4%,60岁以上占16.8%。结论登革热并发肝损害发生率高,主要表现在转氨酶升高,以轻中度多见,且转氨酶升高多处于病程中后期,以成年人为主,中青年患者比例高,经过积极护肝降酶治疗恢复较快、预后良好。Objective To investigate the clinical features of complicated liver damage from dengue fever. Methods Clinical data of 343 cases of dengue fever were retrospectively analyzed. Results Among 343 cases of dengue fever,254 cases（74.05%） had liver damage. 293 cases had bilirabin thesaurismosis and transaminase increase possibly caused by certain reasons but excluding viral hepatitis, fatty liver, alcoholic liver, drug-induced liver damage and hemolysis,which shows a relatively high incidence possibility of liver damage in these cases. ALT abnormalities were accounted for76.03% and AST abnormalities accounted for 88.40%. ALT and AST reached the peak in 8.59 ± 2.56 days and 7.5 ±2.24 days, respectively. Patients younger than 20 years old were accounted for 4.5% of dengue fever; dengue patients between 20 to 40 years old was accounted for 26.4%; dengue fever among patients aged 40 to 60 years old was accounted for 28.4%, and over 60 years. Conclusion The high incidence of dengue fever complicated by liver damage,mainly in the elevated transaminase,commonly light to moderate, and more in the course of elevated transaminase at late stage, mainly in adults, and with a high proportion of young patients. The prognosis was good after liver protection and reducing the transminase level.

关 键 词：登革热 肝损害 丙氨酸氨基转移酶 天冬氨酸氨基转移酶 

分 类 号：R512.8[医药卫生—内科学]