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登革热肝损伤谱:是重症登革热的病因还是结果?

Spectrum of Liver Injury in Dengue Fever: Cause or Effect of Severe Dengue?

作者信息

Khattak Muhammad Irfan, Khattak Samina Naseem, Khattak Muhammad Numan, Hadi Shumaila Numan, Rafique Muhammad, Baloch Sherbano

机构信息

Department of Medicine, PNS Shifa Hospital, Karachi, Pakistan.

Department of Emergency Medicine, Mawson Lakes Medical Centre, South Australia, Australia.

出版信息

J Coll Physicians Surg Pak. 2024 Feb;34(2):241-243. doi: 10.29271/jcpsp.2024.02.241.

Abstract

The study aimed to determine if deranged liver function tests (LFTs) can predict severe dengue or mortality. It included 135 dengue patients, with a mean age of 30.9 ± 12.09 years. Among the patients, 82 (60.7%) were under 30 years of age. Nearly half of the patients (64, 47. 4%) had some degree of liver damage indicated by deranged LFTs, 27 (42.1%) had elevated alanine transaminase (ALT), 7 (10.9%) had increased bilirubin, and 30 (46.9%) had high values of alkaline phosphatase (ALP). However, only elevated ALP levels were positively correlated with mortality (Pearson's R = 0.282, p = <0.05). The mean bilirubin was 11.711 ± 8.602 umol/l, and the mean values of ALT and ALP were 107 ± 240 and 113.571 ± 59.91 IU/L, respectively, which were higher than the normal. The study findings suggested that hepatic derangement is a common occurrence in dengue patients, and increased ALP levels could be an indicator of a higher risk of mortality. These findings can help improve patient care by identifying the potential risk factors for mortality. Key Words: Dengue, Liver function tests, Alanine transaminase, Alkaline phosphatase.

摘要

该研究旨在确定肝功能检查(LFTs)异常是否能够预测重症登革热或死亡率。研究纳入了135例登革热患者,平均年龄为30.9±12.09岁。其中,82例(60.7%)患者年龄在30岁以下。近半数患者(64例,47.4%)存在某种程度的肝损伤,表现为肝功能检查异常,27例(42.1%)患者丙氨酸转氨酶(ALT)升高,7例(10.9%)患者胆红素升高,30例(46.9%)患者碱性磷酸酶(ALP)值升高。然而,只有ALP水平升高与死亡率呈正相关(Pearson相关系数R=0.282,p<0.05)。平均胆红素为11.711±8.602μmol/L,ALT和ALP的平均值分别为107±240和113.571±59.91IU/L,均高于正常水平。研究结果表明,肝脏功能紊乱在登革热患者中较为常见,ALP水平升高可能是死亡率较高的一个指标。这些发现有助于通过识别死亡的潜在危险因素来改善患者护理。关键词:登革热;肝功能检查;丙氨酸转氨酶;碱性磷酸酶

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