呼吸道感染患儿血清丙氨酸氨基转移酶与天冬氨酸氨基转移酶比值与并发肝功能异常的相关性分析  

Correlation analysis of serum alanine aminotransferase to aspartate aminotransferase ratio and concurrent liver function abnormalities in children with respiratory tract infection

作　　者：张玲 王红群 何国华 ZHANG Ling;WANG Hongqun;HE Guohua(Department of Pediatrics,the Second People's Hospital of Wuhu,Wuhu,Anhui 241000,China)

机构地区：[1]芜湖市第二人民医院儿科,安徽芜湖241000

出　　处：《中国优生与遗传杂志》2022年第9期1567-1572,共6页Chinese Journal of Birth Health & Heredity

摘　　要：目的 以呼吸道感染患儿为研究对象,探究其血清丙氨酸氨基转移酶(ALT)与天冬氨酸氨基转移酶(AST)比值与并发肝功能异常的相关性。方法 以2017年1月至2021年12月进行治疗的呼吸道感染患儿(2580例)为研究对象。根据患儿是否有肝功能异常,将患儿分为肝功能异常组(250例)和肝功能正常组(2330例)。收集所有患儿的病原检测结果以及临床资料,通过对比法以及双变量Pearson进行分析。结果 病原体检测结果显示,TORCH检查主要为巨细胞病毒感染(90株,71.43%);呼吸道九项检查主要为副流感病毒(10株,7.94%)、流感病毒A型(9株,7.14%)、流感病毒B型(7株,5.56%)感染。呼吸道感染患儿肝功能异常的发生概率为9.69%(250/2580)。ALT/AST值与TBIL以及R-GT均呈负相关性(P<0.05),即ALT/AST比值越小患儿的肝功能越差。通过ROC曲线评价结果表明,AUC为0.806,灵敏度为95.53%,特异度为64.82%,表明诊断价值尚可。Logistic分析结果显示,年龄1个月~6岁、有肺外表现、有被动吸烟史、重度感染、联合用药、抗菌药物使用≥1周、ALT/AST降低、TBIL升高以及R-GT升高均是肝功能异常的独立危险因素(P<0.05)。预测模型的ROC曲线以及内部数据验证结果显示,模型的AUC为0.818,灵敏度为0.957,特异度为0.692。表明该预测模型的区分度和准确度良好。结论 呼吸道感染患儿易发生巨细胞病毒、副流感病毒、流感病毒感染。肝功能异常患儿的临床症状以发热、咳嗽、肺外表现为主。肝功能异常患儿的TBIL以及R-GT均与ALT/AST比值呈负相关,即ALT/AST比值越小患儿的肝功能越差。Objective To investigate the correlation between the ratio of serum alanine aminotransferase(ALT) to aspartate aminotransferase(AST) and complicated liver function abnormalities in children with respiratory tract infection.Methods A total of 2580 children with respiratory tract infection who were treated in our hospital from January 2017 to December 2021 were selected as the research subjects. According to whether the children had abnormal liver function, they were divided into the abnormal liver function group(250 cases) and the normal liver function group(2330 cases). The pathogen detection results and clinical data of all children were collected, and analyzed by comparison method and bivariate Pearson.Results The results of pathogen detection showed that torch was mainly cytomegalovirus infection(90 strains, 71.43%);The nine respiratory examinations were mainly parainfluenza virus(10 strains, 7.94%), influenza virus type A(9 strains, 7.14%)and influenza virus type B(7 strains, 5.56%). The incidence of abnormal liver function in children with respiratory tract infection was 9.69%(250/2580). ALT/AST was negatively correlated with TBIL and R-GT(P<0.05), that is, the smaller the ALT/AST ratio, the worse the liver function of children. The results of ROC curve evaluation showed that the AUC was 0.806,the sensitivity was 95.53%, and the specificity was 64.82%, indicating that the diagnostic value was acceptable. Logistic analysis results showed that age 1 month to 6 years old, extrapulmonary manifestations, history of passive smoking, severe infection, combined medication, use of antibiotics for ≥1 week, decreased ALT/AST, increased TBIL and increased R-GT were independent risk factors for abnormal liver function(P<0.05). The ROC curve of the prediction model and the results of internal data validation showed that the AUC of the model was 0.818, the sensitivity was 0.957, and the specificity was 0.692.It shows that the prediction model has good discrimination and accuracy. Conclusion Children with respiratory trac

关 键 词：呼吸道感染 儿童 丙氨酸氨基转移酶 天冬氨酸氨基转移酶 肝功能 

分 类 号：R725.6[医药卫生—儿科]