LIVER BIOCHEMICAL TESTS AND DENGUE FEVER
LIVER BIOCHEMICAL TESTS AND DENGUE FEVER
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DOI：
10.4269/ajtmh.1992.47.265
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发表时间：
1992-09-01
影响因子：
3.3
通讯作者：
LIAW, YF
中科院分区：
文献类型：
--
作者：
KUO, CH;TAI, DI;LIAW, YF
在1987年11月至1988年12月的一次登革热暴发期间，对125名男性和145名女性确诊为登革热的患者进行了生化试验，研究了登革热对肝功能的影响。谷草转氨酶（AST）、丙氨酸转氨酶（ALT）、胆红素、碱性磷酸酶和γ-谷氨酰转肽酶（G-GT）的异常率分别为93.3%、82.2%、7.2%、16.3%和83.0%。大多数情况下转氨酶升高为轻度至中度，但分别有11.1%和7.4%的患者AST和ALT高于正常上限10倍。最初，AST水平大于ALT，在症状发作后9天增加到最高水平，然后在两周内下降到正常水平。生化检测结果在有和无B型肝炎或丙型肝炎病毒感染的病例之间无显著差异，但在出血发作的患者中观察到AST、ALT和G-GT显著升高。2例肝活检显示小叶性肝炎的特征。在5例死亡病例中，3例死于肝功能衰竭。结论：登革热可引起与常规病毒性肝炎相似的肝损伤和转氨酶升高。在流行或地方病地区，登革热感染应考虑在肝炎的鉴别诊断。
The impact of dengue on liver function was studied by biochemical tests on 125 male and 145 female patients diagnosed with this disease during an outbreak that extended from November 1987 to December 1988. Abnormal levels of aspartate amino-transferase (AST), alanine aminotransferase (ALT), bilirubin, alkaline phosphatase, and gamma-glutamyl transpeptidase (G-GT) were observed in 93.3%, 82.2%, 7.2%,16.3% and 83.0% of the patients, respectively. The elevation of transaminases was mild to moderate in most cases, but was 10-fold greater than the normal upper limit for AST and ALT in 11.1% and 7.4% of the patients, respectively. Initially, the level of AST was greater than that of ALT, increasing to maximum levels nine days after the onset of symptoms, then decreasing to normal levels within two weeks. Results of the biochemical tests did not differ significantly between the cases with and without hepatitis B or hepatitis C virus infection, but significantly higher elevations of AST, ALT, and G-GT were observed in patients with episodes of bleeding. Liver biopsies of two patients showed features of lobular hepatitis. Of the five fatal cases, three died of hepatic failure. It is concluded that dengue fever may cause hepatic injury and transaminase elevation similar to that in patients with conventional viral hepatitis. In epidemic or endemic areas, dengue fever infection should be considered in the differential diagnosis of hepatitis.