婴幼儿肝功能异常216例临床分析

Retrospective study of 216 cases of infant with liver disfuction

目的研究婴幼儿肝功能异常的病因和临床表现。方法对2487例住院婴幼儿的临床资料进行回顾性分析。结果(1)一般资料分析:216例患儿肝功能异常(8.69%),男115例,女101例,男女差异无统计学意义;按年龄分为1～6月小婴儿组,6月至1岁大婴儿组,1～3岁幼儿组,小婴儿组肝功能异常率(13.66%)高于大婴儿组(9.05%)和幼儿组(6.23%);幼儿组以轻度异常多见(79.69%)。(2)病因分析:病毒感染为主要原因(31.48%),其他原因有细菌感染、药(毒)物损害和遗传代谢病等,各组发病率差异无统计学意义。小婴儿组支原体感染率低于其他两组,差异有统计学意义;小婴儿组和大婴儿组以TORCH(包括弓形体,单纯疱疹Ⅰ、Ⅱ型、风疹病毒、巨细胞病毒)感染多见;幼儿组以EB病毒感染多见,差异有统计学意义,其他病毒包括腺病毒、柯萨奇病毒、轮状病毒、流感病毒等。药(毒)物损害有毒鼠强、毒蘑菇、中草药、头孢曲松钠、丙戊酸钠等。(3)临床表现:无明显临床表现患儿147例(68.06%),黄疸21例(11.57%),肝脏增大42例(19.44%),出血倾向8例(3.70%),合并有心肌损伤36例(16.67%)。结论婴幼儿肝功能异常的主要病因有感染、药(毒)物损害、遗传代谢病等,应重视肝功能检查,合理用药。

Objective To investigate etiology,clinical manifestations in infant with liver disfunction. Methods Clinical data of 216 infant admitted to the Department of Pediatrics of Shandong Provencial Hospital were reviewed retrospectively. Results （1）There were 216 infant （8. 69%）complicated with liver disfunction,including 115 boys and 101girls. The difference between mail and female was not significant. All the children were divided into three groups according to the different age. Group 1 ： 1 month- 6 months, Group 2 ： 6 months -- 1 year old, and Group 3 ： 1 year-3 year-old. There were 13. 66% of the cases with liver disfunction in group 1,which is higher than that of group 2（9.05%） and group 3（6.23%）. Slightly liver disfunction was commom in group 3（79.69%）. （2）The main causes are caused by virus（31.48%） ,bacteria,myeoplasm,drug and congenital metabolic diseases,et al. TORCH vi rus infection rate is high in group 1 and group 2, yet Eb virus infection rate is high in group 3. Other virus including adenovirus, eoxsackie virus, rotavirus, flu virus, et al could also cause the disease. Drugs including tetramine, poison ous mushroom, chinese herbal, ceftriaxone, and valproic acid, et al are among the causes. （3） 147 cases （68.06%） had no abnormal signs and symptoms, with the clinical manifestation including jaundice（2l cases, countedfor 11.57%）, liver enlarge（42 cases, counted for19.44%）, hemorrhage tendency（8 cases, counted for 3.70%）, and myocardial damage（36 cases,counted forl6.67%）. Conclusion Infection of virus,bacteria and mycoplasma,drug,congenital metabolism diseases can induce infant liver disfunction. The liver fuction test is very important. , and drug should be rationally uesd.