非典型肺炎病人血清酶测定及意义

Significance and Determination of the Serum Enzyme for Patients with Severe Acute Respiratory Syndrome

目的 :动态监测非典型肺炎 (SARS)病人血清酶的变化 ,为SARS的治疗和疗效判断提供帮助。方法 :采用回顾性及随访研究方法 ,对本院收治 10 3例SARS病人分别在入院后初期、中期、高峰期、恢复期和随访时作血清酶检查 ,并进行描述性分析及方差分析。结果 :SARS发病初期谷丙转氨酶 (ALT)、谷草转氨酶 (AST)分别有18.8%、40 .6%的患者异常 ,从初期开始均值呈上升态势 (P <0 .0 5 )。肌酸激酶 (CK)初期 2 3 .8%患者异常 ,均值高于正常值 ,随后呈下降态势 (P <0 .0 5 )。CK MB和乳酸脱氢酶 (LDH)各期比较无显著性差异 (P >0 .0 5 )。α 羟丁酸脱氢酶 (α HBDH)、碱性磷酸酶(ALP)和γ 谷氨酰转肽酶 (γ GT)初期均值均正常 ,初期至高峰期均呈上升态势 (P <0 .0 1)。结论 :SARS病人发病初期AST、CK和ALT异常比例高 ,SARS病毒可能未对心肌直接造成损伤 ,但可能对肝脏功能有一定损害。SARS病人血清酶的变化有一定规律 ,可协助治疗和疗效判断 ;

Objective: Dynamic observation on serum enzyme of patients with Severe Acute Respiratory Syndrome(SARS) and service clinical treatment of SARS. Method: Serum enzyme analysis such as ALT, AST, LDH, CK ,ALP, γ GT, CK MB and α HBDH was determined in 103 SARS patients during the first,middle,high peak,recovery and follow up stage. The statistics of results was done.Results: There occurred 18.8% ,40.6% high concentration of ALT,AST during the first stage and their means there occurred 23.8% high concentration of CK during the first stage and its means were in an decreasing tendency( P <0.05).The means of CK MB,LDH during all stage were no significance,respectively.The means of α HBDH,γ GT,ALP were normal during the first stage and were in an increasing tendency from first stage to high peak stage( P <0.05),respectively.Conclusion: There occurred high concentration of AST, CK and ALT usually during the first stage of SARS patients. SARS virus did not impair myocardium directly,may impair liver function at some degree. Serum enzyme of SARS has its own rule. Clinical doctor must analyze serum enzyme of SARS patients dynamically and prevent impairment of other organs.