Zhang X B, Fei Y X, He T, Gao L, Zhang Y T, Gao Y D, Li G, Wang J, Ru Q J, Wang H Q, Chen G Y
The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310018, China.
Zhejiang Chinese Medical University, Hangzhou 310051, China.
Zhonghua Gan Zang Bing Za Zhi. 2021 Mar 20;29(3):265-270. doi: 10.3760/cma.j.cn501113-20191204-00444.
To investigate the correlation between serum ferritin (SF) level and liver damage in the acute stage of dengue fever. A retrospective study was conducted to analyze 171 cases diagnosed with dengue fever as dengue fever group and 130 healthy patients as control group in Hangzhou 3A grade hospital from July to December 2017. Clinical data, SF and liver function related indicators were collected from both groups: alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) to analyze the correlation between liver damage and SF in patients with dengue fever. ALT, AST, and SF levels were significantly higher in the dengue fever group than those in the healthy control group ( = 11.553, 15.054 and 15.163, < 0.001). SF levels were higher in the dengue fever combined with liver damage group than those without the liver damage group ( = 6.930, < 0.001). However, there was no statistically significant differences in age, gender, peak body temperature, and history of liver disease ( > 0.05). In addition, Spearman's correlation analysis showed that SF was positively correlated with ALT, AST, and TBIL ( = 0.464, 0.531 and 0.315, < 0.001). Among dengue patients with different SF levels, there were significant difference in ALT, AST levels and incidence of liver damage ( = 14.240 and 17.584, (2) = 49.547, < 0.001). Patients with higher SF levels had higher ALT, AST levels and incidence of liver damage. Binary logistic regression analysis showed that hyperferritinemia (SF≥500 ng/ml) was the risk factor for dengue fever combined with liver damage ( = 8.120, < 0.001). Furthermore, ROC curve analysis showed that the AUC for SF to judge dengue fever combined liver damage was 0.846 (95% : 0.785-0.908), and the sensitivity and specificity when the SF cut-off value was 1 506 ng/ml were 74.8% and 83.3%. There is a certain correlation between the SF level and the degree of liver damage in acute stage of dengue fever patients, and hyperferritinemia is a risk factor for dengue fever combined with liver damage.
探讨登革热急性期血清铁蛋白（SF）水平与肝损伤的相关性。进行一项回顾性研究，分析2017年7月至12月在杭州某三甲医院确诊为登革热的171例患者作为登革热组，以及130例健康患者作为对照组。收集两组的临床资料、SF及肝功能相关指标：丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL），以分析登革热患者肝损伤与SF的相关性。登革热组的ALT、AST和SF水平显著高于健康对照组（分别为11.553、15.054和15.163，P<0.001）。登革热合并肝损伤组的SF水平高于无肝损伤组（6.930，P<0.001）。然而，两组在年龄、性别、最高体温和肝病病史方面差异无统计学意义（P>0.05）。此外，Spearman相关性分析显示，SF与ALT、AST和TBIL呈正相关（分别为0.464、0.531和0.315，P<0.001）。在不同SF水平的登革热患者中，ALT、AST水平及肝损伤发生率差异有统计学意义（分别为14.240和17.584，χ²=49.547，P<0.001）。SF水平较高的患者ALT、AST水平及肝损伤发生率更高。二元logistic回归分析显示，高铁蛋白血症（SF≥500 ng/ml）是登革热合并肝损伤的危险因素（8.120，P<0.001）。此外，ROC曲线分析显示，SF判断登革热合并肝损伤的AUC为0.846（95%CI：0.785 - 0.908），当SF临界值为1506 ng/ml时，敏感度和特异度分别为74.8%和83.3%。登革热患者急性期SF水平与肝损伤程度存在一定相关性，高铁蛋白血症是登革热合并肝损伤的危险因素。
