Khanduker S, Mojumder M, Ahmed R, Aharama A, Khanduker A, Monika F M
Dr Sadia Khanduker, Associate Professor, Department of Biochemistry, Bangladesh Medical College, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2025 Jan;34(1):166-173.
Dengue is a mosquito-borne infection that in recent years has become a vital disease of international public health concern. Dengue virus infections and illness when symptomatic, that patients tend to present with a significantly wide variety manifestation. The aim of the study was to gauge liver dysfunction in patients with dengue infections. To judge the impact of dengue virus infection on liver function by measuring various liver function tests in blood samples of serologically diagnosed dengue patients. This study was undertaken as an observational cross-sectional study in the period of June 2019 to October 2020. Records of 120 serologically confirmed cases of dengue infection with available biochemical liver function tests, admitted to Bangladesh Medical College Hospital, were analyzed. Patients were classified as classical dengue fever (DF) - 64.1%, dengue haemorrhagic fever (DHF) - 24.1% and dengue shock syndrome (DSS) - 11.6%. The mean age was 36.61±14.55 years. Normal values of alanine aminotransferase (ALT) had 27.0% of patients and 73.0% had values above normal. With regard to AST 12.0% patients had normal values and 88.0% of patients had values above normal. Deranged alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin and total bilirubin was present in 72.0%, 86.0%, 57.0%, 27.0% patients respectively. The mean±SE of ALT, AST, albumin and total bilirubin were 240.38±892.60 U/L, 364.43±1948.03 U/L, 33.30±4.17 gm/L and 1.26±1.14 mg/dl respectively. The mean value of AST was significantly more than ALT. The degree of rise of ALT and AST was significantly more in DHF and DSS, as compared to DF. Mean serum ALT, AST and bilirubin values were significantly higher in patients with haemorrhage as compared to those without haemorrhage and in non-survivors. Serum albumin concentration was significantly lower in DSS than DHF or DF patients. Hepatic dysfunction was quite common altogether types of dengue infection, with AST rising significantly more than ALT. While preferentially high AST may function an early indicator of dengue infection, high ALT and bilirubin and reduce albumin may act as poor prognostic markers.
登革热是一种由蚊子传播的感染性疾病,近年来已成为国际公共卫生关注的重要疾病。登革热病毒感染且出现症状时,患者往往会表现出多种多样的症状。本研究的目的是评估登革热感染患者的肝功能障碍情况。通过检测血清学确诊的登革热患者血样中的各项肝功能指标,来判断登革热病毒感染对肝功能的影响。本研究于2019年6月至2020年10月期间作为一项观察性横断面研究开展。对孟加拉国医学院医院收治的120例血清学确诊的登革热感染病例且有可用生化肝功能检测记录进行了分析。患者被分类为典型登革热(DF)——64.1%,登革出血热(DHF)——24.1%,登革休克综合征(DSS)——11.6%。平均年龄为36.61±14.55岁。丙氨酸转氨酶(ALT)正常的患者占27.0%,73.0%的患者ALT值高于正常。关于天冬氨酸转氨酶(AST),12.0%的患者值正常,88.0%的患者值高于正常。分别有72.0%、86.0%、57.0%、27.0%的患者丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、白蛋白和总胆红素出现异常。ALT、AST、白蛋白和总胆红素的均值±标准误分别为240.38±892.60 U/L、364.43±1948.03 U/L、33.30±4.17 gm/L和1.26±1.14 mg/dl。AST的均值显著高于ALT。与DF相比,DHF和DSS中ALT和AST的升高程度显著更高。与无出血的患者相比,出血患者的血清ALT、AST和胆红素均值显著更高,且在非幸存者中也是如此。DSS患者的血清白蛋白浓度显著低于DHF或DF患者。肝功能障碍在所有类型的登革热感染中都相当常见,AST升高明显多于ALT。虽然AST优先升高可能是登革热感染的早期指标,但ALT和胆红素升高以及白蛋白降低可能是不良预后的标志物。