布鲁氏菌病所致肝功能损伤121例生化指标分析  

Biochemical Analysis of 121 Cases of Liver Injury Caused by Brucellosis

作　　者：齐丽艳 娜仁图雅 包思纳 李涛 其乐格尔 魏诺敏 张丽 金伯旬 QI Liyan;Narentuya;BAO Sina;LI Tao;Qilegeer;WEI Nuomin;ZHANG Li;JIN Boxun(Department of Intensive Care Unit and Severe Liver Disease,No.2 Hospital of Huhhot,Huhhot,Neimenggu 010040,China;Department of Critical Care Medicine,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]呼和浩特市第二医院重症医学肝病科,内蒙古呼和浩特010040 [2]首都医科大学附属北京佑安医院重症医学科,北京100069

出　　处：《中国医药指南》2025年第4期1-5,共5页Guide of China Medicine

基　　金：内蒙古自治区卫生健康委2023年首府地区公立医院高水平临床专科建设项目(2023SGGZ0035)。

摘　　要：目的观察布鲁氏菌病(简称“布病”)所致肝损伤发生率、肝损伤生化改变特征及不同类型肝损伤与患者布病分期、布病抗体和其他布病并发症的关系。方法从呼和浩特市第二医院2023年1月至2023年12月入院患者中筛选出984名布病患者,观察其中布病肝损伤发生率,并观察布病肝损伤患者丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰胺转肽酶(GGT)、碱性磷酸酶(ALP)变化特征,观察以上生化指标与患者布病分期、布病抗体和布病脊柱炎、布病血液系统异常的关系。结果布病肝损伤患者121名,发病率为12.10%,表现生化指标表现分为A型(GGT或ALP升高,ALT和AST正常)、B型(谷氨酰GGT或ALP升高,ALT或AST升高)、C型(ALT或AST升高、GGT和ALP正常),A型与B型占布病肝损伤患者的比例高达83.00%,C型仅占17.00%。A型患者中急性期布病占比最低,而亚急性期、慢性期布病占比最高;C型患者中急性期布病占比最高,亚急性期、慢性期布病占比最低;B型患者中病程构成则为居中。抗体分析提示IgM阴性患者中A型肝损伤患者占有更高比例,IgM阳性患者中C型肝损伤患者占有更高比例。A型、B型、C型患者布病脊柱炎发生率逐步下降,布病相关的血液系统异常则逐步增多。结论布病相关肝损伤具有较高的发生率,细胞酶或胆管酶均可升高,其中以胆管酶升高更为常见;胆管酶升高更多与布病慢性化有关,细胞酶升高更多与急性期布病有关。Objective To observe the incidence of liver injury caused by brucellosis,the biochemical characteristics of liver injury and the relationship between different types of liver injury and brucellosis stages,brucellosis antibody and other complications of brucellosis.Methods A total of 984 inpatients suffering from brucellosis were enrolled from the No.2 Hospital of Hohhot from January 2023 to December 2023,and the incidence rate of brucellosis liver injury was observed.The changes of biochemical indexes related to liver cell damage(alanine aminotransferase ALT,glutamic oxalic aminotransferase AST)and bile pipe lesions(glutamine transpeptidase GGT,alkaline phosphatase ALP)in patients with brucellosis liver injury were also observed.The relationship between the biochemical indexes and brucellosis stages,brucellosis antibody,brucellosis spondylitis and brucellosis blood system abnormality were observed.Results There were 121 patients with blastodermopathy liver injury,with an incidence rate of 12.10%.The biochemical manifestations were classified into type A(elevated GGT or ALP,normal ALT and AST),type B(elevated glutamyl GGT or ALP,elevated ALT or AST),and type C(elevated ALT or AST,normal GGT and ALP).Type A and type B accounted for 83.00%of patients with bruceopathy liver injury,and type C accounted for only 17.00%.The proportion of acute brucellosis was the lowest in type A patients,while the proportion of subacute brucellosis and chronic brucellosis were the highest.The proportion of acute brucellosis was the highest in type C patients,and the proportion of subacute brucellosis and chronic brucellosis was the lowest.In type B patients,the course of disease was in the middle.Antibody analysis indicated A higher proportion of patients with type A liver injury in IgM negative patients and a higher proportion of patients with type C liver injury in IgM positive patients.The incidence of brucellosis spondylitis in patients with type A,type B and type C gradually decreased,and brucellosis related blood system abnormali

关 键 词：布鲁氏菌病 肝损伤 丙氨酸氨基转移酶 天冬氨酸氨基转移酶 谷氨酰胺转肽酶 碱性磷酸酶 布鲁氏菌病分期 

分 类 号：R575[医药卫生—消化系统] R378.5[医药卫生—内科学]