Jacquemin E, Saliba E, Blond M H, Chantepie A, Laugier J
Department of Paediatrics, Clocheville Children's Hospital, Tours, France.
Eur J Pediatr. 1992 Oct;151(10):731-4. doi: 10.1007/BF01959078.
We report 15 children who developed transient liver dysfunction related to hepatic ischaemia. All patients had cardiocirculatory failure 24 h before the onset of liver injury (day 1). Peak serum values of transaminases occurred between day 1 and day 3: SGOT (mean: 759 IU/l, range: 150-4400); SGPT (418 IU/l, 95-2547). Transaminase values decreased rapidly and normalised from day 6 to day 10. Minimum values of prothrombin test (PT) occurred on day 1 (31%, 10-70) and 13/15 patients had a PT less than 50% (27%, 10-44). PT values normalized from day 3 to day 10. Hypoglycaemia was present in 8/15 patients on day 1. Liver dysfunction improved after correction of the circulatory failure. These results confirm that transient hepatic dysfunction, probably as a consequence of hepatic hypoperfusion, may occur frequently in children after acute circulatory failure. We conclude that the diagnosis of ischaemic liver injury or shock liver syndrome in children can be made on clinical and biochemical criteria, and that liver biopsy is unnecessary.
我们报告了15例发生与肝脏缺血相关的短暂性肝功能障碍的儿童。所有患者在肝损伤发作前24小时（第1天）均出现心循环衰竭。转氨酶的血清峰值出现在第1天至第3天之间：谷草转氨酶（平均：759 IU/L，范围：150 - 4400）；谷丙转氨酶（418 IU/L，95 - 2547）。转氨酶值从第6天到第10天迅速下降并恢复正常。凝血酶原试验（PT）的最低值出现在第1天（31%，10 - 70），15例患者中有13例PT低于50%（27%，10 - 44）。PT值从第3天到第10天恢复正常。8/15的患者在第1天出现低血糖。循环衰竭纠正后肝功能障碍得到改善。这些结果证实，短暂性肝功能障碍，可能是肝灌注不足的结果，在急性循环衰竭后的儿童中可能经常发生。我们得出结论，儿童缺血性肝损伤或休克肝综合征的诊断可以根据临床和生化标准做出，肝活检是不必要的。
