儿童肝脏酶学异常328例病因分析

Analysis of 328 children with elevated aminotransferase levels.

目的探讨儿童肝脏酶学异常的病因。方法对2001年11月至2004年10月以肝脏酶学异常为主要原因,收住复旦大学附属儿科医院的328例患儿通过查阅病历进行回顾性分析。结果328例患儿中52例(15.9%)未能明确病因,38例存在肝脏酶学异常重叠性疾病(11.6%)。引起儿童肝脏酶学异常的前6位疾病(有重叠)分别为巨细胞病毒(CMV)肝炎(156例)、乙型病毒性肝炎(46例)、甲型病毒性肝炎(30例)、胆管闭锁(30例)、肝豆状核变性(12例)、糖原累积病(12例);CMV肝炎是1岁以下儿童肝脏酶学异常最常见的病因,3岁以上儿童肝脏酶学异常以甲、乙型病毒性肝炎为主。结论儿童肝脏酶学异常的病因多种多样,仍需深入研究;以CMV肝炎为首因的婴儿肝病综合征及以甲、乙型病毒性肝炎为主的病毒性肝炎是儿童肝脏酶学异常的主要病因,加强上述疾病的防治具有重要意义。

Objective To investigate the causes of elevated aminotransferase levels of children. Methods Medical records of 328 cases hospitalized with elevated aminotransferase levels from November,2001 to October,2004 were consulted and the causes of elevated aminotransferase levels were analysed. Results 52 （ 15.9% ） cases were not diagnosed, and 38 cases with overlapping diseases that could cause elevated aminotransferase levels were found. The first 6 causes of elevated aminotransferase levels of children were cytomegalovirus （CMV） hepatitis （ 156）, hepatitis B （46）, hepatitis A （30）, biliary atresia （ 30）, hepatolenticular degeneration （ 12 ） and hepato-glycogenosis （ 12 ）. CMV hepatitis was most common in the cases below 1 year old. Hepatitis A and B were the main causes of elevated aminotransferase levels of children above 3 years old. Conclusion The causes of elevated aminotransferase levels of children are various and deserve researching deeply. CMV hepatitis and hepatitis A and B are the main causes of elevated aminotransferase levels of children. There is much significance to prevent them.