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首页> 外文期刊>World Journal of Gastroenterology >Clinical significance of hepatic derangement in severe acute respiratory syndrome.
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Clinical significance of hepatic derangement in severe acute respiratory syndrome.

机译：严重急性呼吸综合征的肝功能紊乱的临床意义。

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AIM: Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. METHODS: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. RESULTS: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5XULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5X ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P = 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P = 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P = 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. CONCLUSION: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome.
机译：目的：在患有严重急性呼吸系统综合症（SARS）的患者中，丙氨酸氨基转移酶（ALT）水平升高是常见的现象。我们报告了一大群SARS患者的肝脏紊乱的进展和临床意义。方法：对符合SARS WHO标准的患者进行血清ALT的系列测定。将ALT升高的患者与肝功能正常的患者进行临床比较。检查乙型肝炎病毒（HBV）感染的血清学。不良结局定义为氧饱和度下降，需要重症监护病房（ICU）以及机械通气和死亡。结果：该研究纳入了294例患者。入院时七十（24％）名患者的血清ALT升高，而在随后的病程中204（69％）名患者的ALT升高。使用ALT> 5XULN峰作为临界值，并在调整了潜在的混杂因素后，对于氧气去饱和的ALT> 5X ULN峰的比值比为3.24（95％CI 1.23-8.59，P = 0.018），ICU护理为3.70（ 95％CI 1.38-9.89，P = 0.009），机械通气为6.64（95％CI 2.22-19.81，P = 0.001），死亡为7.34（95％CI 2.28-24.89，P = 0.001）。在随访期间，有93％的存活患者的ALT水平恢复正常或呈改善趋势。慢性乙型肝炎与较差的临床预后无关。结论：反应性肝炎是SARS冠状病毒感染的常见并发症。那些患有严重肝炎的患者的临床预后较差。

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