Islam M T, Islam M N, Mollah A H, Hoque M A, Hossain M A, Nazir F, Ahsan M M
Department of Paediatrics, Dhaka Medical College, Dhaka, Bangladesh.
Mymensingh Med J. 2011 Jul;20(3):446-9.
Because of hypoxemia, different organ systems of the body are affected in perinatal asphyxia. In this study, the functional status of liver of the asphyxiated babies was assessed through estimation of liver enzymes to see any correlation existing between enzyme changes and severity of perinatal asphyxia. A total of 70 full-term asphyxiated newborns (study group) were studied during January'2008 to December'2008 in the department of Paediatrics, Mymensingh Medical College Hospital. After enrollment these babies were grouped according to Sarnat & Sarnat stages of Hypoxic-ischemic encephalopathy (HIE) as stage I, II & III. Babies who are small for gestational age, having severe jaundice, sepsis or congenital anomalies of the hepatobiliary system were excluded from the study. Another 50 healthy newborns were also studied as control group. Venous blood was analyzed between 2nd and 5th day of life to estimate serum AST, ALT & alkaline phosphatase (ALP). Unpaired student's 't' test and Spearman's rank correlation was used for data analysis and P value of <0.05 were considered significant. Mean AST, ALT and ALP of the asphyxiated babies were 76.27±37.44, 82.16±48.08 & 369.59±123.05 U/L and that of normal babies were 23.46±8.45, 26.54±7.76 & 208.20±46.95 U/L respectively and these rise were statistically significant (p<0.001). The levels of transaminases and ALP were positively correlated with the severity of asphyxia and these correlations were also statistically significant (p<0.001). So, this study concludes that AST, ALT & ALP significantly elevated in perinatal asphyxia and this elevation was proportional to the severity of hypoxia.
由于低氧血症，围产期窒息会影响身体的不同器官系统。在本研究中，通过评估肝酶来评估窒息婴儿肝脏的功能状态，以观察酶变化与围产期窒息严重程度之间是否存在相关性。2008年1月至2008年12月期间，在迈门辛医学院医院儿科对70名足月窒息新生儿（研究组）进行了研究。纳入研究后，这些婴儿根据缺氧缺血性脑病（HIE）的萨纳特和萨纳特分期分为I期、II期和III期。小于胎龄、患有严重黄疸、败血症或肝胆系统先天性异常的婴儿被排除在研究之外。另外50名健康新生儿也作为对照组进行了研究。在出生后第2天至第5天采集静脉血，以评估血清谷草转氨酶（AST）、谷丙转氨酶（ALT）和碱性磷酸酶（ALP）。采用非配对学生t检验和斯皮尔曼等级相关分析进行数据分析，P值<0.05被认为具有统计学意义。窒息婴儿的平均AST、ALT和ALP分别为76.27±37.44、82.16±48.08和369.59±123.05 U/L，正常婴儿的分别为23.46±8.45、26.54±7.76和208.20±46.95 U/L，这些升高具有统计学意义（p<0.001）。转氨酶和ALP水平与窒息严重程度呈正相关，这些相关性也具有统计学意义（p<0.001）。因此，本研究得出结论，围产期窒息时AST、ALT和ALP显著升高，且这种升高与缺氧严重程度成正比。
