血清转氨酶在腹部闭合伤后肝损伤诊断及分级中的临床应用(1)
[摘要]目的 观察血清转氨酶在腹部闭合伤后肝损伤诊断及分级中的应用价值。方法 以我院2013年1月～2017年12月收治的50例腹部闭合性损伤患者为研究对象，根据疾病类型分为肝损伤组和无肝损伤组，每组各25例。检测两组患者的谷氨酰转肽酶(GGT)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转氨酶(AST)、胆红素、丙氨酸氨基转移酶(ALT)水平和白细胞(WBC)水平。结果 将肝损伤组分为重度组和轻度组，其中，重度组的LDH、AST、ALT水平均明显高于轻度组，差异有统计学意义(P<0.05)，轻度组的ALT、AST、LDH水平均高于无损伤组，差异有统计学意义(P<0.05)。轻度肝损伤患者不同级别的ALT、AST、LDH水平比较，差异有统计学意义(P<0.05)，GGT、胆红素、WBC水平比较，差异无统计学意义(P>0.05)。结论 血清ALT、AST值在腹部闭合性损伤肝损伤诊断及分級中具有重要作用，可为临床医生治疗腹部闭合性损伤提供参考方法及经验。
[关键词]肝脏受损;腹部闭合损伤;转氨酶;分级
[中图分类号] R656 [文献标识码] A [文章编号] 1674-4721(2019)7(c)-0049-03
[Abstract] Objective To observe the application value of serum transaminase in the diagnosis and grading of liver injury after abdominal closed injury. Methods From January 2013 to December 2017， 50 patients with abdominal closed injury treated in our hospital were selected as study objects. According to the type of disease， the patients were divided into the liver injury group and non-liver injury group， 25 cases in each group. The levels of glutamyl transpeptidase (GGT)， lactate dehydrogenase (LDH)， aspartate aminotransferase (AST)， bilirubin， alanine aminotransferase (ALT) and leukocyte (WBC) were measured in patients of both groups. Results The liver injury group was divided into the severe group and mild group. The levels of LDH， AST and ALT in the severe group were significantly higher than those in mild group， and the differences were statistically significant (P<0.05). The levels of ALT， AST and LDH in the mild group were higher than those in the non-injury group， and the differences were statistically significant (P<0.05). There were significant differences in ALT， AST and LDH levels among different grades of patients with mild liver injury (P<0.05). There were no significant differences in GGT， bilirubin and WBC levels (P>0.05). Conclusion Serum ALT and AST values play an important role in the diagnosis and grading of liver injury caused by closed abdominal injury， which can provide a reference method and experience for clinicians in treating closed abdominal injury.
[Key words] Liver damage; Abdominal closed injury; Transaminase; Grading
腹部闭合性损伤中，肝损伤较为常见，为造成该疾病患者死亡的主要原因之一。早期诊断、治疗该疾病可有效指导该疾病的治疗，降低患者的死亡率[1]。腹部创伤超声重点评估方案(FAST)检测盆腔及腹腔的游离液体具有较强的敏感性，主要为急诊腹部创伤超声重点评估方案，诊断钝性肝损伤的灵敏度不高，且当无游离液体，仅有肝实质损伤时，灵敏度更低。存在诸多局限[2]。计算机断层(CT)扫描为诊断腹部损伤的重要检查手段，在可疑腹部损伤患者检查诊断中具有重要作用，但CT不是卫生机构都具备，因此可能会延误某些严重损伤的诊断，且CT扫描价值较高，部分患者无法承受，在诊断腹部闭合性损伤中也具有一定的限制[3]。临床上发现血清转氨酶与肝损伤之间的关系密切，因此，本研究以我院腹部闭合性损伤患者为研究对象，观察腹部闭合性损伤肝损伤诊断及分级中，血清转氨酶的作用，现报道如下。, 百拇医药(甘华 陈劲霜 聂志红 徐俊 熊军辉)
[关键词]肝脏受损;腹部闭合损伤;转氨酶;分级
[中图分类号] R656 [文献标识码] A [文章编号] 1674-4721(2019)7(c)-0049-03
[Abstract] Objective To observe the application value of serum transaminase in the diagnosis and grading of liver injury after abdominal closed injury. Methods From January 2013 to December 2017， 50 patients with abdominal closed injury treated in our hospital were selected as study objects. According to the type of disease， the patients were divided into the liver injury group and non-liver injury group， 25 cases in each group. The levels of glutamyl transpeptidase (GGT)， lactate dehydrogenase (LDH)， aspartate aminotransferase (AST)， bilirubin， alanine aminotransferase (ALT) and leukocyte (WBC) were measured in patients of both groups. Results The liver injury group was divided into the severe group and mild group. The levels of LDH， AST and ALT in the severe group were significantly higher than those in mild group， and the differences were statistically significant (P<0.05). The levels of ALT， AST and LDH in the mild group were higher than those in the non-injury group， and the differences were statistically significant (P<0.05). There were significant differences in ALT， AST and LDH levels among different grades of patients with mild liver injury (P<0.05). There were no significant differences in GGT， bilirubin and WBC levels (P>0.05). Conclusion Serum ALT and AST values play an important role in the diagnosis and grading of liver injury caused by closed abdominal injury， which can provide a reference method and experience for clinicians in treating closed abdominal injury.
[Key words] Liver damage; Abdominal closed injury; Transaminase; Grading
腹部闭合性损伤中，肝损伤较为常见，为造成该疾病患者死亡的主要原因之一。早期诊断、治疗该疾病可有效指导该疾病的治疗，降低患者的死亡率[1]。腹部创伤超声重点评估方案(FAST)检测盆腔及腹腔的游离液体具有较强的敏感性，主要为急诊腹部创伤超声重点评估方案，诊断钝性肝损伤的灵敏度不高，且当无游离液体，仅有肝实质损伤时，灵敏度更低。存在诸多局限[2]。计算机断层(CT)扫描为诊断腹部损伤的重要检查手段，在可疑腹部损伤患者检查诊断中具有重要作用，但CT不是卫生机构都具备，因此可能会延误某些严重损伤的诊断，且CT扫描价值较高，部分患者无法承受，在诊断腹部闭合性损伤中也具有一定的限制[3]。临床上发现血清转氨酶与肝损伤之间的关系密切，因此，本研究以我院腹部闭合性损伤患者为研究对象，观察腹部闭合性损伤肝损伤诊断及分级中，血清转氨酶的作用，现报道如下。, 百拇医药(甘华 陈劲霜 聂志红 徐俊 熊军辉)