Johnson R D, O'Connor M L, Kerr R M
Department of Pathology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, USA.
Am J Gastroenterol. 1995 Aug;90(8):1244-5.
To determine the frequency, etiology, and associated mortality of extreme elevations of serum AST.
The medical records were reviewed of all patients with a serum AST over 3000 U/L during 1 full calendar year at a large, tertiary-care hospital. Serum AST, with an upper limit of normal at 35 U/L, is included in the automated, 18-test chemistry profile run on virtually all clinically ill patients admitted to this hospital.
Of 23,125 admissions, 56 patients had or developed serum AST concentrations greater than 3000 U/L, an occurrence rate of approximately two per 1000 admissions. Either liver or skeletal muscle was the origin of virtually all such AST elevations. Acute hypotension (ischemic or hypoxic hepatitis) accounted for the majority (29/56) of the cases; toxic (seven) or viral (four) hepatitis together accounted for 11/56 cases. Overall mortality, on this admission, was 31/56 (55%).
Extreme elevations of AST are most often attributable to hypoxic hepatitis. Patients with extreme AST due to hypoxic hepatitis had a 22/29 (75%) mortality compared with 9/27 (33%) for all other causes combined.
确定血清谷草转氨酶（AST）极度升高的发生率、病因及相关死亡率。
回顾了一家大型三级医院一整个日历年中血清AST超过3000 U/L的所有患者的病历。血清AST的正常上限为35 U/L，包含在该医院几乎所有临床患病住院患者进行的18项自动化学检测项目中。
在23125例住院患者中，56例患者的血清AST浓度达到或超过3000 U/L，发生率约为每1000例住院患者中有2例。几乎所有此类AST升高均源于肝脏或骨骼肌。急性低血压（缺血性或缺氧性肝炎）占多数病例（29/56）；中毒性（7例）或病毒性（4例）肝炎共占11/56病例。此次住院的总体死亡率为31/56（55%）。
AST极度升高最常见的原因是缺氧性肝炎。因缺氧性肝炎导致AST极度升高的患者死亡率为22/29（75%），而其他所有原因导致的死亡率为9/27（33%）。
