泰国儿童严重登革病毒感染所致急性肝衰竭的结局
Outcome of Severe Dengue Viral Infection-caused Acute Liver Failure in Thai Children.
作者信息
Laoprasopwattana Kamolwish, Jundee Puthachat, Pruekprasert Pornpimol, Geater Alan
机构信息
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
出版信息
J Trop Pediatr. 2016 Jun;62(3):200-5. doi: 10.1093/tropej/fmv099. Epub 2016 Feb 6.
To determine clinical course and outcomes of liver functions in children with dengue viral infection-caused acute liver failure (ALF), the records of patients aged <15 years attending our institution during 1989-2011 were reviewed. Of the 41 ALF patients, 2, 6 and 33 patients had dengue hemorrhagic fever grade II, III and IV, respectively. Multiorgan failure including respiratory failure, massive bleeding and acute kidney injury occurred in 80.0%, 96.0% and 84.0% of the ALF cases, respectively, with an overall fatality rate of 68.3%. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were highest on the day that the patient developed ALF. Lactate dehydrogenase levels had positive correlations with AST (r = 0.95) and ALT (r = 0.87) (all p < 0.01). The median (interquartile range) days before the AST and ALT levels returned to lower than 200 U/L after the ALF were 10.5 (8.8, 12.8) and 10.5 (7.8, 14.0) days, respectively.
为了确定登革病毒感染所致急性肝衰竭（ALF）患儿的肝功能临床病程及转归，我们回顾了1989年至2011年期间在我院就诊的15岁以下患者的记录。在41例ALF患者中，分别有2例、6例和33例患有II级、III级和IV级登革出血热。多器官功能衰竭，包括呼吸衰竭、大出血和急性肾损伤，分别发生在80.0%、96.0%和84.0%的ALF病例中，总病死率为68.3%。天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）水平在患者发生ALF当天最高。乳酸脱氢酶水平与AST（r = 0.95）和ALT（r = 0.87）呈正相关（所有p < 0.01）。ALF后AST和ALT水平恢复至低于200 U/L之前的中位（四分位间距）天数分别为10.5（8.8，12.8）天和10.5（7.8，14.0）天。
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