Mohan B, Patwari A K, Anand V K
Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India.
J Trop Pediatr. 2000 Feb;46(1):40-3. doi: 10.1093/tropej/46.1.40.
Hepatic functions of 61 children, diagnosed to have dengue infection (DI), aged 2 months to 12 years comprising 37 cases of dengue fever (DF), 16 with dengue hemorrhagic fever (DHF), and eight with dengue shock syndrome (DSS) were prospectively studied during the acute attack. Hepatomegaly (74 per cent), epistaxis (26 per cent), jaundice (25 per cent), and petechial rashes (18 per cent) were the common clinical manifestations of DI. On admission, levels of serum aspartate transaminase (AST), serum alanine transaminase (ALT) and serum alkaline phosphatase (AP) were raised in 80-87 per cent of children with hepatomegaly (group I) and 81 per cent of cases without hepatomegaly (group II). During the second week of hospitalization the proportion of cases with raised levels of AST, ALT, AP and serum bilirubin increased and the mean levels were significantly higher (p < 0.05) in both the groups. These levels gradually declined over the next 2-3 weeks. All the cases with DSS and DHF had raised AST, ALT and AP levels and the mean levels of these enzymes were significantly higher (p < 0.05) as compared to DF. Our results suggest a transient derangement of liver functions in childhood DI, more so in DSS and DHF, with or without hepatomegaly.
对61例确诊为登革热感染（DI）的2个月至12岁儿童的肝功能进行了前瞻性研究，这些儿童包括37例登革热（DF）、16例登革出血热（DHF）和8例登革休克综合征（DSS），研究在急性发作期进行。肝肿大（74%）、鼻出血（26%）、黄疸（25%）和瘀点疹（18%）是登革热感染的常见临床表现。入院时，80 - 87%有肝肿大的儿童（I组）和81%无肝肿大的病例（II组）血清天冬氨酸转氨酶（AST）、血清丙氨酸转氨酶（ALT）和血清碱性磷酸酶（AP）水平升高。在住院的第二周，AST、ALT、AP和血清胆红素水平升高的病例比例增加，两组的平均水平均显著更高（p < 0.05）。这些水平在接下来的2 - 3周逐渐下降。所有登革休克综合征和登革出血热病例的AST、ALT和AP水平均升高，与登革热相比，这些酶的平均水平显著更高（p < 0.05）。我们的结果表明，儿童登革热感染时肝功能会出现短暂紊乱，在登革休克综合征和登革出血热中更为明显，无论有无肝肿大。
