登革热并发肝功能损害与血小板、白细胞的相关性分析

Analysis the damages of liver and the correlation with platelets and leukocytes by Dengue Fever

目的分析登革热并发肝脏功能损害的临床表现及特征与血小板及白细胞的相关性。方法对2014年9~11月收治的823例登革热患者的临床资料进行回顾性分析。通过对登革热患者丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、总胆红素（TB）及白细胞（WBC）、血小板（PLT）的检测,分析登革热并发肝脏功能受损害的情况及其与WBC、PLT的相关性。结果823例登革热患者中并发肝脏功能损害者共582例（70.7%）,其中丙氨酸氨基转移酶（ALT）升高447例（占54.3%）,门冬氨酸氨基转移酶（AST）升高554例（67.3%）,而总胆红素（TB）升高仅66例（8%）,血小板减少者602例（74.0%）,白细胞减少者596例（73.3%）。儿童及中老年登革热患者合并肝脏功能损害的发生率较青少年患者要高。ALT、AST在病程的7~14 d高于病程的7d内及14 d后,差异有统计学意义,而TB在病程的7 d内升高明显,但与病程的7~14 d及14 d后相比较无明显差别。登革热患者血清中ALT、AST、TB的改变与同期静脉血中WBC、PLT改变无显著相关性。结论登革热患者并发肝脏功能损害是登革热病程中多系统器官功能损害中一个多发和常见的局部表现之一,其与年龄及病程有关,而与WBC及PLT无关。

Objective To analyze the clinical characteristics of patients with dengue fever complication with liver damage,and that correlation with platelets and leukocytes.Methods The clinical data of 823 patients with dengue fever in our hospital from Septembe to november in 2014 were analyzed retrospectively.To analyze the liver damage caused by dengue fever and its correlation with WBC and PLT,the level of alanine amino transferase（ALT）,and aspartate amino shift enzyme（AST）,total bilirubin（TB）and the count of white blood cell（WBC）,platelet（PLT）were detected.Results Among 823 cases dengue fever,582 cases（70.7%）showed liver damage,447 cases（54.3%）had high level alanine aminotransferase（ALT）,554 cases（67.3%）had high level aspartate aminotransferase（AST）,while only 66 patients（8%）had high level total bilirubin（TB）.Among 823 cases dengue fever,602 cases（74.0%）showed platelets decline,and 596 cases（73.3%）showed leukocytes decline.The incidence of liver damage in children and elderly patients with dengue fever was higher than in the young patients.The ALT and AST levels of of patients with dengue fever in the course of 7-14 days compared in the course within 7 days and 14 days later was higher,the difference was statistically significant.While the TB increased significantly during the course of 7 days,and had no obvious difference compared with the course of 7-14 days and 14 days.There was no significant correlation between the AST,TB and ALT in the serum and PLT and WBC counts in the venous blood changes of the patients with dengue fever during the same period.Conclusion The liver damage of dengue fever patients is one of the multiple and common local manifestations of the multiple system organ damage in the course of dengue fever.And it is related to age and duration of the disease,while it has no correlation with WBC and PLT.