严重急性呼吸综合征患者肝功能损害的动态观察

Dynamic observation of liver function test in patients with SARS

目的 动态观察严重急性呼吸综合征(SARS)患者的肝功能损害情况。方法 125例SAPS患者均在发病第1周、2周、4周、8周、12周空腹采血进行血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和其他相关指标的动态监测,分析总结SARS病程中各肝功能指标的变化规律。结果 在SARS病程的第1、2周ALT开始升高,第4周后随病情好转开始缓慢下降,持续到第8周左右,到病程第12周才能完全恢复正常,重型患者比普通型患者恢复得慢。在SARS病程中AST升高不多,且在病程第4-8周时能很快恢复正常,重型患者升高的幅度较普通型患者高。部分病例的其他肝功能指标在ALT、AST峰值时有一过性改变,但很快恢复正常。结论 SAPS患者存在明显的肝功能损害,且恢复较慢,提示在临床诊治过程中要注意护肝治疗。

Objective To study the dynamic change of serum alanine aminotransferase(ALT), aspartale aminotransferase(AST) and other liver function tests in patients with severe acute respiratory syndrome(SARS). Methods The serum ALT, AST activity were measured dynamically in 125 patients with SARS at 1st week, 2nd week, 4th week, 8th week and 12th week. Result The levels of serum ALT activity increased at 1st or 2nd week, but after management ALT levels decreased slightly in 4th week and lasted to 8th week. At 12th week, ALT levels became normal. The normalization of ALT in severe SARS patients were significantly slower than that in the mild SARS. The AST was not obviously increased in SARS patients compared with the ALT and most of them became normal at 4th-8th week. The AST levels in severe SARS patients were significantly higher than those in mild SARS group. Other liver function indicators in some SARS patients increased temporarily when serum ALT and AST reached to peak and then they recovered quickly. Conclusion SARS often compromises liver function obviously, so it suggests that some measures should be taken to protect liver in the management of SARS.