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时间:2020-05-24
《腹部闭合性损伤后转氨酶水平在肝损伤诊断中的应用.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、lIl血蚰MedJ,Jun.2ol4'VoL25,No.12海南医学2014年6月第2S卷第l2期doi:10.3969~.issn.1003—6350.2014.12.0690著·腹部闭合性损伤后转氨酶水平在肝损伤诊断中的应陈国。,程亮。,周险峰(重庆市开县第二人民医院普外科、检验科,重庆405402)【摘要】目的探讨腹部闭合性损伤后肝脏转氨酶水平在肝损伤诊断中的作用。方法采用回顾性研究,收集2006年1月至2010年l2月因腹部闭合性损伤在我院治疗的175例患者病历资料,肝损伤的程度通过CT扫描或手术探查证实。采用ROC曲线评
2、估丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)和丫谷氨酰转肽酶(GGT)在肝损伤诊断中的最佳阈值。结果ALT、AST、LDH和GGT诊断肝损伤的最佳阈值分别为60U/L、115u/L、590U/L和53U/L;血清中ALT、AST、LDH和GGT超过其阈值诊断肝损伤的OR值分别为63.7(95%CI:26.13-174.25,P<0.001)、29.9(95%CI:12.471.73,P3、.014)。结论腹部闭合性损伤合并肝脏转氨酶水平异常的患者提示存在肝损伤,ALT>60u/L和AST>I15U/L的患者需要进一步影像学检查和积极处理。【关键词J肝损伤;闭合性损伤;转氨酶;回顾性研究【中图分类号】R656【文献标识码】A【文章编号】1003----6350(2014)12一l777—o4Roleoflivertransaminaselevelsinthediagnosisofliverinjuryafterbluntabdominaltrauma.CHENGuoCHENGI2ang,ZHOU,2.Departme4、ntofGeneralSurgeryDepartmentofClinicalLaboratory,SecondPeople"sHospitalofKaiCountryofChongqingMunicipality,Chongqing405402,CHINA【Abstract】0bj~tiveToinvestigatetheroleoflivertransaminaselevelsinthediagnosisofliverinjuryafterbluntabdominaltrauma.MethodsInthisretrospecti5、vestudy,weincludedl75patientswhohadsustainedbluntab.dominalinjuryandweretreatedatourinstitutionbetweenJanuary2006andDecember2010.ThegradingoftheliverinjuryWaSverifiedusingCTscansorsurgicalfmdings.Usingreceiveroperatingcharacteristic(ROe)curveassess-ment,optimumalanine6、aminotransferase(ALT),aspartateaminotransferase(AST),lactatedehydrogenase(LDH)andT-glutamyltranspeptidase(GGT)thresholdswereanalyzed.ResultsOptimum舭AST,LDHandGGTthresholdsweredeterminedtobe60U/L,ll5U/L,590U/Land53U/L._一T>60U/L(O63.7;95%CI:26.13—174.25;P<0.OO1),AST>l157、U/L(O1L29.9;95%Ch12.46-71.73;P<0.001),LDH>590U/L(O3.7;95%CI:2.12—7.37;P<0.OO1)andGGT>53U(O&3.1;95%CI:1.35—7.42;P-0.014)werestronglyassociatedththepresenceofliver论in¨juries.用ConclusionInpatientswithbluntabdominaltrauma,abnormalhepatictransaminaselevelsareassociatedwith8、liverinjuries.Patientswith脚>60U/LandAST>115U/Larestronglyassociatedmliverinjuryandrequirefurtherinaagingstudiesandclosemanag
3、.014)。结论腹部闭合性损伤合并肝脏转氨酶水平异常的患者提示存在肝损伤,ALT>60u/L和AST>I15U/L的患者需要进一步影像学检查和积极处理。【关键词J肝损伤;闭合性损伤;转氨酶;回顾性研究【中图分类号】R656【文献标识码】A【文章编号】1003----6350(2014)12一l777—o4Roleoflivertransaminaselevelsinthediagnosisofliverinjuryafterbluntabdominaltrauma.CHENGuoCHENGI2ang,ZHOU,2.Departme
4、ntofGeneralSurgeryDepartmentofClinicalLaboratory,SecondPeople"sHospitalofKaiCountryofChongqingMunicipality,Chongqing405402,CHINA【Abstract】0bj~tiveToinvestigatetheroleoflivertransaminaselevelsinthediagnosisofliverinjuryafterbluntabdominaltrauma.MethodsInthisretrospecti
5、vestudy,weincludedl75patientswhohadsustainedbluntab.dominalinjuryandweretreatedatourinstitutionbetweenJanuary2006andDecember2010.ThegradingoftheliverinjuryWaSverifiedusingCTscansorsurgicalfmdings.Usingreceiveroperatingcharacteristic(ROe)curveassess-ment,optimumalanine
6、aminotransferase(ALT),aspartateaminotransferase(AST),lactatedehydrogenase(LDH)andT-glutamyltranspeptidase(GGT)thresholdswereanalyzed.ResultsOptimum舭AST,LDHandGGTthresholdsweredeterminedtobe60U/L,ll5U/L,590U/Land53U/L._一T>60U/L(O63.7;95%CI:26.13—174.25;P<0.OO1),AST>l15
7、U/L(O1L29.9;95%Ch12.46-71.73;P<0.001),LDH>590U/L(O3.7;95%CI:2.12—7.37;P<0.OO1)andGGT>53U(O&3.1;95%CI:1.35—7.42;P-0.014)werestronglyassociatedththepresenceofliver论in¨juries.用ConclusionInpatientswithbluntabdominaltrauma,abnormalhepatictransaminaselevelsareassociatedwith
8、liverinjuries.Patientswith脚>60U/LandAST>115U/Larestronglyassociatedmliverinjuryandrequirefurtherinaagingstudiesandclosemanag
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