瑞安市高三学生谷丙转氨酶异常影响因素分析  

Causes of abnormal alanine transaminase in college entrance physical examination of high school students in Rui'an

作　　者：陈孝祥 姜米佳 冯维良[1] 邓通洋 邹跃玲 

机构地区：[1]浙江省瑞安市人民医院妇幼分院检验科,325200

出　　处：《中国学校卫生》2016年第4期576-578,582,共4页Chinese Journal of School Health

基　　金：2015年瑞安市科技创新项目(MS2015019)

摘　　要：目的了解瑞安市高三学生高考体检谷丙转氨酶(ALT)异常的原因,为有效防控高三年级学生肝功能异常提供依据。方法选取参加2014年和2015年瑞安市高考体检的学生(男生6 734名,女生6 216名),空腹检测肘静脉血谷丙转氨酶。随机选取100名ALT≥80 U/L的学生为异常组,150名健康学生(ALT<40 U/L)为对照组,对其进行进一步检测可能相关指标,同时发放问卷调查学生相关信息。结果 ALT异常占总体检人数的1.07%(139/12 950),ALT异常组性别构成(男生占88%,女生占12%)与对照组(男生占56%,女生占44%)差异有统计学意义(χ2=28.62,P<0.01)。单因素分析显示,ALT异常组与对照组比较,BMI,SUA,AST,TG,TC,LDL、乙肝大三阳、饮食习惯、睡眠时间、近期用药史差异均有统计学意义(P值均<0.01);多因素Logistic回归分析显示,肝胆疾病史、TG、饮食习惯、LDL、BMI、SUA为ALT异常的危险因素(OR值分别为36.15,8.80,4.35,3.03,1.42,1.02)。在调整其他因素影响的条件下,低脂饮食与合理搭配饮食比较,前者患病的风险是后者的2.40和4.35倍;有肝胆疾病史与无肝胆疾病史比较,前者患病的风险是后者的36.15倍;BMI每增加1个单位,患病风险增加1.42倍。结论瑞安市高三学生高考体检谷丙转氨酶异常与多种因素有关。应加大相关知识的宣传,以降低学生ALT异常率。Objective To study the causes of abnormal alanine transaminase in college entrance physical examination of high school students in Rui＇an, so as to provide basis for intervention for abnormal liver function of high school graduates. Methods High school graduates（ 6 734 boys and 6 216 girls） participating in college entrance examination in Rui＇an in 2014 and 2015 were selected. The patients were detected for alanine transaminase（ ALT） from elbow venous blood under fasting condition. 100 students whose ALT equal to or more than 80 U / L were randomly selected as the abnormal group, and 150 healthy students（ ALT40 U / L）were chosen as the control group. Possible related indexes were further detected. A questionnaire at the same time was given out to investigate student＇s related information. Results Subjects with abnormal ALT accounted for 1. 07% of all participants（ 139 / 12950）.And the sex ratio（ male 88%, 88 / 100; female 12%, 12 / 100） of the abnormal ALT group was higher than that of the control group（ male 56%, 84 / 150; female 44%, 66 / 150）（ P〈0.01）. The univariate analysis showed that there were statistically significant differences between the abnormal ALT group and the control group in BMI, SUA, AST, TG, TC, LDL, indicators for hepatitis B,diet habit, sleep time, and recent medical history（ P〈0.01）. Multi-factor logistic regression analysis showed that history of gallbladder and liver disease, TG, diet habits, LDL, BMI, and SUA were risk factors for abnormal ALT（ corresponding OR values were 36.15, 8.80, 4.35, 3.03, 1.42, 1.02）. Based on adjustment of the other influence factors, the risk of low-fat diet was 2.40 times that of thereasonable collocation food（ 95%CI = 0.53-10.89, P = 0.2569）; The risk of high-fat diet was 4.35 times that of thereasonable collocation food（ 95%CI = 6.36-12.84, P = 0.01）; The risk of patients with a history of gallbladder and liver disease was 36.15 that of the patients without a history of gallbladder and liver disease（

关 键 词：肝功能不全 回归分析 学生保健服务 

分 类 号：R179[医药卫生—妇幼卫生保健] R195.2[医药卫生—公共卫生与预防医学]