儿童哮喘发作对肝功能指标的影响  

Effect of Asthma Exacerbation on Liver Function Indexes in Children

作　　者：周立娜[1] 朱旭明 张健[2] 陈茜 崔玉宝 ZHOU Lina;ZHU Xuming;ZHANG Jian;CHEN Qian;CUI Yubao(Department of Respiratory Medicine,Wuxi Children′s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Department of Clinical Laboratory,Wuxi Children′s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Department of Clinical Laboratory,Wuxi People′s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡儿童医院呼吸科,江苏无锡214023 [2]南京医科大学附属无锡儿童医院检验科,江苏无锡214023 [3]南京医科大学附属无锡人民医院检验科,江苏无锡214023

出　　处：《医学综述》2021年第12期2478-2482,共5页Medical Recapitulate

基　　金：江苏省重点研发计划(BE2018627)。

摘　　要：目的了解儿童哮喘发作对肝功能指标的影响。方法选取2019年1—12月在南京医科大学附属无锡儿童医院就诊的80例哮喘急性发作住院儿童作为哮喘发作组,其中轻度组54例、中度组17例、重度组9例,选取同时期35例无过敏性和感染性疾病的体检儿童作为对照组。比较哮喘发作组和对照组及不同哮喘发作严重程度组的血清总胆红素(TBIL)、总蛋白(TP)、白蛋白(ALB)、前白蛋白(PALB)、碱性磷酸酶(ALP)、丙氨酸转氨酶(ALT)、γ谷氨酰转肽酶(GGT)、天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、腺苷脱氨酶(ADA)、胆碱酯酶(CHE)、α-岩藻糖苷酶(AFU)、胆汁酸(BA)水平。结果哮喘发作组TBIL、ALB、PALB、ALP、CHE低于对照组[(7.0±2.5)μmol/L比(9.7±3.9)μmol/L,(42.2±3.5)g/L比(43.8±2.4)g/L,(160.5±44.4)mg/L比(219.0±35.7)mg/L,(230.9±73.0)U/L比(271.1±79.4)U/L,(8433±1680)U/L比(9708±2026)U/L](P<0.05或P<0.01),LDH、BA高于对照组[316(274,366)U/L比240(211,268)U/L,3.3(2.1,5.7)μmol/L比2.1(1.3,4.6)μmol/L](P<0.05或P<0.01),两组TP、ALT、GGT、AST、ADA、AFU比较差异无统计学意义(P>0.05)。哮喘发作轻度组、中度组和重度组TBIL、TP、ALB、PALB、ALP、ALT、GGT、AST、LDH、ADA、CHE、AFU、BA比较差异无统计学意义(P>0.05)。结论哮喘发作可能导致儿童ALB、PALB代谢异常,哮喘发作时LDH升高,但尚无充分证据证明儿童哮喘发作可引起肝细胞损伤,未发现儿童哮喘发作严重程度与肝功能指标相关。Objective To understand the effects of asthma exacerbation on liver function indexes in children.Methods A total of 80 children suffered from exacerbated asthma were hospitalized in Wuxi Children′s Hospital Affiliated to Nanjing Medical University from Jan.to Dec.2019 and were regarded as an asthma group,including a mild group(54 cases),a moderate group(17 cases)and a severe group(9 cases).A total of 35 children with no allergic and infectious diseases during the same period were included as a control group.Serum levels of total bilirubin(TBIL),total protein(TP),albumin(ALB),prealbumin(PALB),alkaline phosphatase(ALP),alanine transaminase(ALT),glutamyl transpeptidase(GGT),aspartate transaminase(AST),lactic dehydrogenase(LDH),adenosine deaminase(ADA),cholinesterase(CHE),α-fucosidase(AFU),bile acid(BA)were compared among different groups.Results Levels of TBIL,ALB,PALB,ALP and CHE were lower in the asthma group compared with control group[(7.0±2.5)μmol/L vs(9.7±3.9)μmol/L,(42.2±3.5)g/L vs(43.8±2.4)g/L,(160.5±44.4)mg/L vs(219.0±35.7)mg/L,(230.9±73.0)U/L vs(271.1±79.4)U/L,(8433±1680)U/L vs(9708±2026)U/L](P<0.05 or P<0.01),LDH and BA were higher in the asthma group compared with control group[316(274,366)U/L vs 240(211,268)U/L,3.3(2.1,5.7)μmol/L vs 2.1(1.3,4.6)μmol/L](P<0.05 or P<0.01).There were no statistical differences of TP,ALT,GGT,AST,ADA,AFU between the asthma group and the control group(P>0.05).There was no significant difference in TBIl,TP,ALB,PALB,ALP,ALT,GGT,AST,LDH,ADA,CHE,AFU and BA among the mild,moderate and severe asthma attack groups(P>0.05).Conclusion Asthma exacerbation may lead to metabolic disturbances of ALB and PALB.Levels of LDH increase in children with asthma exacerbation.There is no sufficient evidence to support that asthma exacerbation can result in live function injury in children,and it is not discovered that the severity of asthma exacerbation is correlated with liver function indexes in children.

关 键 词：哮喘 肝功能 白蛋白 前白蛋白 乳酸脱氢酶 

分 类 号：R562.1[医药卫生—呼吸系统]