Wang Gang, Tang Cui, Wang Rui, Xu Chundao, Shen Tugang, Li Gaokai
School of Life and Health, Huzhou College, Huzhou, Zhejiang, China.
Zhejiang Xinda Hospital, Huzhou, Zhejiang, China.
Front Med (Lausanne). 2025 Aug 1;12:1570474. doi: 10.3389/fmed.2025.1570474. eCollection 2025.
To investigate the relationship between liver function indices (AST, ALT, GGT) and inflammatory markers (CRP, white blood cell count) in multiple injury patients at different time points post-trauma.
We retrospectively analyzed 114 patients with multiple injuries admitted to a tertiary trauma center in Zhejiang Province (January 2023-December 2024). AST, ALT, GGT, CRP, white blood cell count, NLR, and LMR were measured at admission, 24 h, and 72 h post-admission. Age, drinking history, BMI, and gender were included as covariates. Statistical analyses employed both crude and adjusted GEE models with gender subgroup analysis.
Elevated CRP levels significantly correlated with increased AST (OR = 2.17, 95% CI: 1.14-4.12, = 0.019) and ALT (OR = 2.37, 95% CI: 1.22-4.63, = 0.011). The 72 h time point independently predicted ALT elevation (OR = 2.24, 95% CI: 1.37-3.65, < 0.001). NLR (OR = 0.94, 95% CI: 0.90-0.99, = 0.014) and WBC count (OR = 1.89, 95% CI: 1.12-3.18, = 0.017) significantly predicted GGT elevation. Gender-stratified analysis revealed distinct patterns: In females, CRP elevation (both ≥40 mg/L and 10-40 mg/L) was inversely associated with AST ( < 0.05), and higher WBC correlated with lower GGT ( = -0.636, = 0.017). In males, higher WBC was associated with lower AST; ALT decreased at 24 h ( = -1.08, < 0.001) and 72 h ( = -1.11, < 0.001); CRP 10-40 mg/L inversely correlated with ALT ( = -0.882, = 0.008); and both higher WBC ( = -0.812, = 0.013) and NLR ( = -0.063, = 0.013) predicted lower GGT.
CRP and white blood cell count significantly correlate with liver function changes in multiple injury patients, with marked gender-specific differences in these associations. These findings suggest the need for sex-specific monitoring strategies in trauma-related hepatic dysfunction.
探讨多发伤患者创伤后不同时间点肝功能指标（谷草转氨酶、谷丙转氨酶、γ-谷氨酰转肽酶）与炎症标志物（C反应蛋白、白细胞计数）之间的关系。
我们回顾性分析了浙江省一家三级创伤中心收治的114例多发伤患者（2023年1月至2024年12月）。在入院时、入院后24小时和72小时测量谷草转氨酶、谷丙转氨酶、γ-谷氨酰转肽酶、C反应蛋白、白细胞计数、中性粒细胞与淋巴细胞比值及淋巴细胞与单核细胞比值。将年龄、饮酒史、体重指数和性别作为协变量。统计分析采用粗模型和校正后的广义估计方程模型，并进行性别亚组分析。
C反应蛋白水平升高与谷草转氨酶升高（比值比=2.17，95%置信区间：1.14 - 4.12，P=0.019）和谷丙转氨酶升高（比值比=2.37，95%置信区间：1.22 - 4.63，P=0.011）显著相关。72小时时间点可独立预测谷丙转氨酶升高（比值比=2.24，95%置信区间：1.37 - 3.65，P<0.001）。中性粒细胞与淋巴细胞比值（比值比=0.94，95%置信区间：0.90 - 0.99，P=0.014）和白细胞计数（比值比=1.89，95%置信区间：1.12 - 3.18，P=0.017）显著预测γ-谷氨酰转肽酶升高。性别分层分析显示出不同模式：在女性中，C反应蛋白升高（≥40mg/L和10 - 40mg/L）与谷草转氨酶呈负相关（P<0.05），白细胞计数越高，γ-谷氨酰转肽酶越低（r=-0.636，P=0.017）。在男性中，白细胞计数越高，谷草转氨酶越低；谷丙转氨酶在24小时（r=-1.08，P<0.001）和72小时（r=-1.11，P<0.001）下降；C反应蛋白10 - 40mg/L与谷丙转氨酶呈负相关（r=-0.882，P=0.008）；白细胞计数升高（r=-0.812，P=0.013）和中性粒细胞与淋巴细胞比值升高（r=-0.063，P=0.013）均预测γ-谷氨酰转肽酶降低。
C反应蛋白和白细胞计数与多发伤患者肝功能变化显著相关，这些关联存在明显的性别差异。这些发现表明在创伤相关肝功能障碍中需要采用针对性别的监测策略。
