Penndorf V, Saner F, Gerken G, Canbay A
Universitätsklinikum Essen, Abteilung für Gastroenterologie und Hepatologie, Essen, Deutschland.
Universitätsklinikum Essen, Abteilung für Allgemein-, Viszeral- und Transplantationschirurgie, Essen, Deutschland.
Zentralbl Chir. 2013 Dec;138(6):636-42. doi: 10.1055/s-0031-1271601. Epub 2012 May 7.
Elevated liver function tests in ICU-bound patients are associated with a greater risk of mor-tality. Chronic liver diseases as well as acute events and complications of therapy are among the causes. The disorder could further be investigated by assessment of liver cell integrity markers (AST, ALT and GLDH), cholestasis parameters -(bilirubin, GGT, ALP) and liver synthethic function (albumin, coagulation profile). Ultrasound and elastography are cheap and mobile options to evaluate chronic liver disease, cholestasis or perfusion of the liver. The interpretation of the results should include the medical history on the ICU. Liver injury could be due to septic or isch-aemic complications as well as toxic side effects or parenteral nutrition. The main therapeutic option is to identify the cause of the liver dysfuntion and to eliminate it as far as possible.
入住重症监护病房（ICU）的患者肝功能检查结果升高与更高的死亡风险相关。病因包括慢性肝病以及治疗的急性事件和并发症。可通过评估肝细胞完整性标志物（谷草转氨酶、谷丙转氨酶和谷氨酸脱氢酶）、胆汁淤积参数（胆红素、γ-谷氨酰转肽酶、碱性磷酸酶）和肝脏合成功能（白蛋白、凝血指标）来进一步调查该病症。超声和弹性成像检查是评估慢性肝病、胆汁淤积或肝脏灌注情况的低成本且便捷的方法。结果解读应包括患者在ICU的病史。肝损伤可能是由于感染性或缺血性并发症以及毒性副作用或肠外营养所致。主要的治疗方法是确定肝功能障碍的原因并尽可能消除它。
