闭合性腹部外伤患者血清肝转氨酶水平变化及其与肝损伤的相关性分析

Changes of Serum Transaminase Level in Patients with Blunt Abdominal Trauma and their Correlation with Liver Injury

目的:探究血清肝转氨酶水平在闭合性腹部外伤患者中的变化及其在肝损伤中的表达及意义。方法:选取2010年8月至2017年8月本院收治的闭合性腹部外伤患者157例为研究对象。根据有无肝损伤将患者分为肝损伤组(77例)、无肝损伤组(80例)。对肝损伤组参照美国创伤外科学会(AAST)确立的分级标准分为肝损伤轻度组(Ⅰ~Ⅱ级,32例)、中度组(Ⅲ级,22例)、重度组(IV^V级,23例);根据治疗方式分为手术治疗组(32例)、保守治疗组(45例)。观察比较上述各组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(GGT)表达水平。结果:肝损伤组ALT、AST、GGT水平分别为(274.15±33.19)U/L、(283.65±35.42)U/L、(46.24±6.07)U/L,高于无肝损伤组的(35.06±4.72)U/L、(58.96±7.21)U/L、(25.62±3.81)U/L,差异有统计学意义(t=63.773、55.562、25.595,P<0.05)。重度组ALT、AST、GGT水平均高于中度组、轻度组(P<0.05);中度组ALT、AST、GGT水平又高于轻度组(P<0.05)。手术治疗组ALT、AST、GGT水平均高于保守治疗组,但差异无统计学意义(P>0.05)。结论:闭合性腹部外伤患者血清肝转氨酶水平升高对肝损伤具有较高诊断价值,并可提示肝损伤严重程度。

Objective:To investigate the changes of serum liver transaminase levels in patients with closed abdominal trauma and its significance in liver injury.Methods:A total of 157 patients with closed abdominal trauma admitted to our hospital from August 2010 to August 2017 were selected as the study objects.The patients were divided into liver injury group(77 cases)and no liver injury group(80 cases)according to the presence or absence of liver injury.According to the grading standards established by the American College of Trauma Surgery(AAST),the liver injury group was divided into two groups:mild liver injury group(I-II grade,32 cases),moderate grade group(III grade,22 cases)Grade,23 cases).According to the treatment,they were divided into operation group(32 cases)and conservative group(45 cases).The expression levels of alanine aminotransferase(alt),aspartate transaminase(AST)andγ-glutamyltransferase(GGT)were observed and compared.Results:the levels of ALT,AST and GGT in liver injury group were(274.15±33.19)U/L,(283.65±35.42)U/L,(46.24±6.07)U/L,which was higher than that in the group without liver injury(35.06±4.72)U/L,(58.96±7.21)U/L,(25.62±7.21)U/L,the difference was statistically significant(t=63.773,55.562,25.595,P<0.05).The levels of ALT,AST and GGT in severe group were higher than those in mild group and mild group(P<0.05).The levels of ALT,AST and GGT in moderate group were higher than those in mild group(P<0.05).The levels of ALT,AST and GGT in the surgical treatment group were higher than those in the conservative treatment group,but the difference was not statistically significant(P>0.05).Conclusion:The elevated level of serum liver transaminase in patients with closed abdominal trauma has high diagnostic value for liver injury and may indicate the severity of liver injury.