小儿钝性腹部外伤与血清转氨酶升高的临床意义探讨

The significance of elevated liver transaminases in children with blunt abdominal trauma

目的探讨血清谷氨酸草酰乙酸转氨酶(AST)和血清谷氨酸丙酮酸转氨酶(ALT)升高在小儿钝性腹部创伤的意义。方法87例血液动力学稳定的患儿为观察对象,对照研究49例腹部创伤与38例非腹部创伤患儿及CT证实腹内脏器损伤和无腹内脏器损伤组的AST与ALT的水平变化。结果腹部创伤组与非腹部创伤组的AST与ALT水平差异有显著性(P<0.05)。腹内脏器损伤组的AST与ALT(分别为333.6±283.3和197.5±192.5)与无腹内脏器损伤组的值(分别为84.2±55.9,43±29.8)差异也有非常显著性(P<0.001)。结论肝功能检测可以作为小儿钝性腹部创伤可靠的辅助检查。

Objective To evaluate the significance of elevated serum glutamic oxaloacetic transaminase（AST） and serum glutamic pyruvic transaminase（ALT） levels with intra-abdominal injury in children. Methods 87 haemodynamically stable injured children were observed prospectively. 49 cases with abdominal trauma and 38 cases with trauma of other parts of the body as controls （Groups Ⅰ and Ⅱ）.Patients with intra-abdominal injury verified by CT were further compared with negative CT patients （Group Ⅰb and Ⅰa）. Results There was significant difference in AST and ALT levels of Groups Ⅰ and Ⅱ （P〈0.05）. AST and ALT levels were 333.6±283.8 and,197.5±192.5 U/L.respectively in Group Ⅰb;but 84.2（AST）±55.9,43±29.8 U/L in Group Ⅰa（P〈0. 001）. Conclusion Liver transaminase tests may be used as screening method in children with blunt abdominal trauma.