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1.
Journal of Chinese Physician ; (12): 236-241, 2023.
Article in Chinese | WPRIM | ID: wpr-992290

ABSTRACT

Objective:To investigate the value of liver ultrasonic elasticity index combined with aspartate aminotransferase to platelet ratio index (APRI), fibrosis index based on the four factors (FIB-4) and globulin platelet model (GP) in the diagnosis of autoimmune hepatitis complicated with liver cirrhosis.Methods:From January 2020 to January 2022, 82 patients with autoimmune hepatitis and cirrhosis treated in West China Hospital of Sichuan University were selected as observation group, and 90 patients with autoimmune hepatitis were selected as controls (control group). All of them underwent liver ultrasound elastic examination, and the APRI, FIB-4, GP of patients were calculated. The differences of shear wave velocity (SWV), liver hardness value (LSM), strain rate ratio (SR), APRI, FIB-4, GP between the two groups were compared. At the same time, the differences of SWV, LSM, SR, APRI, FIB-4 and GP among patients with autoimmune hepatitis with different degrees of liver fibrosis and inflammation were analyzed. The value of liver ultrasound elasticity index, APRI, FIB-4 and GP in predicting autoimmune hepatitis complicated with cirrhosis was evaluated by the receiver operating characteristic (ROC) curve.Results:The SWV, LSM, FIB-4 and GP in the observation group were (1.60±0.21)m/s, (13.98±1.82)kPa, (8.10±1.43) and (4.15±1.05) respectively, which were significantly higher than those in the control group (all P<0.05), while SR and APRI were (5.04±0.98) and (2.41±0.92) respectively, which were significantly lower than those in the control group (all P<0.05). With the aggravation of liver fibrosis, the levels of SWV, LSM, FIB-4 and GP in patients with autoimmune hepatitis were higher (all P<0.05), while the SR and APRI were lower (all P<0.05). There was no statistically significant difference in SWV, LSM, SR, APRI, FIB-4 and GP between patients with G1-G2 and G3-G4 inflammatory degree of autoimmune hepatitis (all P>0.05). SWV, LSM, SR, APRI, FIB-4 and GP were included in the binary logistic regression analysis, and SWV, FIB-4 and GP were finally selected as independent predictors for diagnosis of autoimmune hepatitis with cirrhosis (all P<0.05). The area under the ROC curve of combined prediction of SWV, FIB-4 and GP for autoimmune hepatitis with cirrhosis was 0.931, which was significantly higher than other indicators (all P<0.05), and the sensitivity and specificity were 95.00% and 84.00% respectively. Conclusions:Liver ultrasonic elasticity index, APRI, FIB-4 and GP are related to the degree of liver fibrosis in patients with autoimmune hepatitis. SWV, FIB-4 combined with GP have high application value in predicting autoimmune hepatitis complicated with liver cirrhosis.

2.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1211-1215, 2023.
Article in Chinese | WPRIM | ID: wpr-991888

ABSTRACT

Objective:To investigate the efficacy of peginterferon alfa-2a (Peg-IFNα-2a) combined with entecavir in sequential treatment of chronic hepatitis B.Methods:A total of 106 patients with chronic hepatitis B who received treatment in Affiliated Hangzhou Xixi Hospital of Zhejiang University School of Medicine from January 2020 to February 2022 were included in this study. They were divided into a control group (entecavir treatment, n = 53) and a study group (sequential therapy with Peg-IFNα-2a followed by entecavir, n = 53). Liver function indicators, liver fibrosis indicators, clinical treatment efficacy, and incidence of adverse reactions were compared between the two groups before and after treatment. Results:After treatment, total bilirubin, alanine aminotransferase and aspartate transaminase in the control and study groups were (94.79 ± 8.71) μmol/L and (67.67 ± 9.19) μmol/L, (256.93 ± 44.07) U/L and (186.56 ± 48.37) U/L, (256.47 ± 43.73) U/L and (200.69 ± 41.34) U/L, and they were (140.05 ± 26.15) μmol/L and (141.32 ± 25.35) μmol/L, (433.66 ± 77.16) U/L and (429.77 ± 73.73) U/L, (352.34 ± 65.19) U/L and (354.05 ± 66.13) U/L before the treatment. After treatment, these indexes in each group were decreased compared with before treatment ( t = 19.19, -12.13, -28.85, -20.96, -19.27, -12.03, all P < 0.05). After treatment, these indexes in the study group were significantly lower than those in the control group ( t = -6.49, -7.30, -6.74, all P < 0.001). After treatment, the levels of hyaluronic acid, laminin, type III procollagen peptide, and type IV collagen in the control and study groups were (124.91 ± 22.99) μg/L and (101.29 ± 22.67) μg/L, (132.71 ± 25.37) μg/L and (110.56 ± 25.49) μg/L, (116.93 ± 20.29) μg/L and (93.14 ± 20.39) μg/L, (63.14 ± 12.19) μg/L and (50.81 ± 11.63) μg/L, and they were (175.73 ± 48.56) μg/L and (177.61 ± 48.51) μg/L, (163.43 ± 41.52) μg/L and (165.57 ± 41.59) μg/L, (139.71 ± 31.75) μg/L and (141.72 ± 31.78) μg/L, (106.97 ± 32.24) μg/L and (104.02 ± 34.12) μg/L before treatment. After treatment, the levels of these indexes in each group were significantly decreased compared with before treatment ( t = -13.04, -8.68, -10.43, -5.82, -13.35, -6.26, -13.02, -10.72, all P < 0.05). After treatment, the levels of these indexes in the study group were significantly lower than those in the control group ( t = -5.32, -4.48, -6.02, -5.32, all P < 0.001). The total response rate in the study group was 88.68% (47/53), which was significantly higher than 62.26% (33/53) in the control group ( χ2 = 9.98, P < 0.05). The HBsAg conversion rate in the study group was 33.96% (18/53), which was significantly higher than 1.32% (6/53) in the control group ( χ2 = 7.75, P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the study and control groups [26.42% (14/53) vs. 30.19% (16/53), χ2 = 0.81, P > 0.05]. Conclusion:Sequential therapy with Peg-IFNα-2a followed by entecavir can effectively improve liver function,reduce liver fibrosis , improve clinical treatment efficacy, and will not increase adverse reactions.

3.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1189-1193, 2023.
Article in Chinese | WPRIM | ID: wpr-991884

ABSTRACT

Objective:To investigate the clinical characteristics of drug-induced liver injury and provide a theoretical basis for the prevention and treatment of drug-induced liver injury.Methods:The clinical data of 202 patients with complete information on drug-induced liver injury who received treatment in First Hospital of Shanxi Medical University from November 2018 to November 2021 were collected. The information including gender, age, type and name of drugs taken or exposed, clinical characteristics, autoantibodies, and liver function was statistically analyzed.Results:Among the 202 patients with drug-induced liver injury, 77 patients (38.1%) were male and 125 patients (61.9%) were female. Age distribution was mainly at > 40-60 years. There were 141 cases (69.8%) of hepatocellular type, 27 cases (13.4%) of cholestatic type, and 34 cases (16.8%) of mixed type. There were statistically significant differences in alanine aminotransferase, aspartate aminotransferase, γ-glutamine transferase, alkaline phosphatase, prothrombin time, international standardized ratio, and prothrombin activity between different clinical types ( H = 91.43, 58.65, 9.25, 32.69, 9.56, 8.19, 9.40, all P < 0.05). Among the 202 patients with drug-induced liver injury, severe liver injury occurred in the largest proportion of cases (40.6%). There was no significant difference in the disease severity between different clinical types ( P = 0.789). The top three types of drugs causing liver injury were traditional Chinese medicine [52.0% (105/202)], antineoplastic drugs [6.4% (13/202)], and antipsychotics [5.9% (12/202)]. The detection rate of autoantibodies in 202 patients with drug-induced liver injury was 29.7% (60/202). Conclusion:Drug-induced liver injury lacks specificity in clinical manifestations. A wide variety of drugs can cause liver injury. Clinicians should strengthen liver function monitoring in key populations. The proportion of patients with mixed-type liver failure is high, which should be taken seriously. When patients with drug-induced liver injury are positive for liver disease-related antibodies, clinicians should be vigilant about the possibility of drug-induced liver injury.

4.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 810-813, 2023.
Article in Chinese | WPRIM | ID: wpr-991824

ABSTRACT

Objective:To investigate the relationship between the peak load of Epstein-Barr virus (EPV) and live function damage in children with infectious mononucleosis caused by EPV.Methods:Eighty children with infectious mononucleosis caused by EPV who received treatment in Pingxiang People's Hospital from January 2018 to December 2021 were included in this study. Five mL of venous blood was taken from each child for detecting the peak load of EBV-DNA and liver function indicators. These children were divided into a low-load group ( n = 25, EBV-DNA load < 10 4 copies/mL), a medium-load group ( n = 34, EBV-DNA load of 10 4-10 5 copies/mL), and a high-load group ( n = 21, EBV-DNA load > 10 5 copies/mL) according to the peak EBV-DNA load. The relationships between different peak loads of EBV-DNA and live function, age, and sex were analyzed. Results:The rate of liver dysfunction in the high-load group [85.71% (18/21)] was significantly higher than [38.24% (13/34)] in the medium-load group and [20.00% (5/25)] in the low-load group ( χ2 = 11.90, 19.71, P = 0.001, P < 0.001). Alanine aminotransferase and aspartate aminotransferase levels in the high-load group were (156.24 ± 13.21) U/L and (171.69 ± 13.49) U/L, respectively, which were significantly higher than (125.89 ± 10.54) U/L and (143.26 ± 10.29) U/L in the medium-load group and (89.64 ± 6.75) U/L and (64.89 ± 5.74) U/L] in the low-load group (all P < 0.001). There was no significant difference in the peak load of EBV-DNA between children of different ages and between children of different sexes (both P > 0.05). Conclusion:Children with infectious mononucleosis caused by EPV have a high EBV-DNA peak load. A higher peak load of EVB-DNA indicates a higher risk of liver function damage. More attention should be paid in clinical practice. Effective diagnosis and treatment should be performed in time to control the patient's condition as early as possible.

5.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 552-556, 2023.
Article in Chinese | WPRIM | ID: wpr-991784

ABSTRACT

Objective:To analyze the diagnostic and prognostic values of the red blood cell distribution width-to-platelet count ratio (RPR) for hepatitis B and liver cirrhosis.Methods:The clinical data of 80 patients with hepatitis B and liver cirrhosis who were diagnosed and treated in Yiwu Central Hospital from June 2020 to August 2021 were retrospectively analyzed. These patients were included in the hepatitis B and liver cirrhosis group. They were subdivided into survival ( n = 69) and death ( n = 11) groups according to their prognosis outcomes. Eighty patients with chronic hepatitis B were included in the chronic hepatitis B group. Eighty healthy controls who concurrently underwent physical examination were included in the control group. The diagnostic and prognostic values of RPR, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis index based on four factors (FIB-4) for hepatitis B and liver cirrhosis were analyzed. Results:Red blood cell distribution width, alanine transaminase, and aspartate transaminase in the hepatitis B and liver cirrhosis group and chronic hepatitis B group were significantly higher compared with the control group (all P < 0.05). Platelet count in the hepatitis B and liver cirrhosis group and chronic hepatitis B group was significantly lower than that in the control group (both P < 0.05). Red blood cell distribution width in the hepatitis B and liver cirrhosis group was significantly higher than that in the chronic hepatitis B group [(18.25 ± 3.28)% vs. (14.67 ± 2.15)%, t = 8.16, P < 0.05]. Platelet count, alanine transaminase, and aspartate transaminase levels in the hepatitis B and liver cirrhosis group were (78.47 ± 11.43) × 10 9/L, (49.48 ± 6.85) U/L, (45.86 ± 6.28) U/L, respectively, which were significantly lower than (133.36 ± 18.42) × 10 9/L, (128.36 ± 15.40) U/L, (98.67 ± 14.41) U/L in the chronic hepatitis B group ( t = -22.65, -41.86, -30.05, all P < 0.05). PRP, APRI, and FIB-4 in the hepatitis B and liver cirrhosis group were (0.23 ± 0.05), (1.85 ± 0.44), (4.25 ± 0.81) respectively, which were significantly higher than (0.11 ± 0.02), (1.46 ± 0.33), (3.38 ± 0.63) in the chronic hepatitis B group ( t = 19.93, 6.34, 7.58, all P < 0.001). The RPR, APRI, and FIB-4 in the death group were (0.25 ± 0.08), (1.97 ± 0.48), (4.52 ± 1.31), respectively, which were significantly higher than (0.18 ± 0.05), (1.68 ± 0.40), (3.69 ± 1.21) in the survival group ( t = 3.94, 2.17, 2.09, all P < 0.05). The receiver operating characteristic curve revealed that PRP has an extremely high value in diagnosing hepatitis B and liver cirrhosis and predicting the death of patients with hepatitis B and liver cirrhosis. Conclusion:RPR has an extremely high value in diagnosing hepatitis B and liver cirrhosis and predicting the prognosis of this disease.

6.
Journal of Clinical Hepatology ; (12): 2144-2147, 2021.
Article in Chinese | WPRIM | ID: wpr-904858

ABSTRACT

Objective To investigate whether there was a correlation between serum liver enzyme levels and blood pressure in the Chinese Han population with nonalcoholic fatty liver disease (NAFLD) in Shandong coastal regions in China. Methods A total of 269 NAFLD patients who lived in Shandong coastal regions and attended or underwent physical examination in Qingdao Municipal Hospital from December 2019 to June 2020 were enrolled, among whom 105 had hypertension and 164 did not have hypertension. Morning blood pressure was measured to calculate mean arterial pressure (MAP), and laboratory tests were performed to measure the serum levels of liver enzymes [alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP)] and fasting blood glucose (FBG). The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. A Pearson correlation analysis was used to investigate the correlation of four liver enzymes with the indices including MAP, and a binary logistic regression model was used to analyze the impact of serum liver enzymes on hypertension. Results Compared with the non-hypertension group, the hypertension group had significantly higher body mass index (BMI), MAP, and GGT (all P < 0.05). For all NAFLD patients and the NAFLD patients without hypertension, male patients had significantly higher BMI, MAP, ALT, AST, and GGT than female patients (all P < 0.05), and for the NAFLD patients with hypertension, male patients had a significantly higher level of GGT than female patients ( P < 0.05). There was a significant difference in the distribution of GGT between the hypertension group and the non-hypertension group, and compared with the non-hypertension group, the hypertension group had a significantly higher proportion of patients with GGT exceeding the normal range ( χ 2 =4.781, P =0.029). Serum GGT level was correlated with MAP within the normal range (70-105 mm Hg) ( r =0.178, P =0.011), while there was no significant correlation when MAP exceeded the normal range ( P =0.415). After adjustment for age and sex, the binary logistic regression model showed that AST level was positively associated with hypertension in the population with NAFLD (odds ratio [ OR ]=1.011, 95% confidence interval [ CI ]: 1.000-1.022, P =0.040), and after further adjustment for BMI and FBG, the results showed that AST level was still positively associated with hypertension ( OR =1.011, 95% CI : 1.000-1.022, P =0.044). Conclusion In Chinese Han population with NAFLD in Shandong coastal regions, higher levels of AST may predict an increased risk of hypertension.

7.
Journal of Clinical Hepatology ; (12): 2109-2112, 2021.
Article in Chinese | WPRIM | ID: wpr-904853

ABSTRACT

Objective To investigate the clinical value of alpha-fetoprotein (AFP) combined with gamma-glutamyl transpeptidase (GGT)/aspartate aminotransferase (AST) ratio in the diagnosis of hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC). Methods A total of 352 subjects who received treatment or underwent physical examination in Renmin Hospital of Wuhan University from January 15 to June 15, 2020, were enrolled, among whom there were 86 healthy controls (HC group), 68 patients with chronic hepatitis B (CHB group), 69 patients with liver cirrhosis (LC group), and 129 patients with HCC (HCC group), and a retrospective analysis was performed for the serological test results of all subjects. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups, and the Nemenyi method was used for further comparison between two groups. A binary logistic regression analysis was used to calculate predictor variables; a receiver operating characteristic (ROC) curve was plotted for AFP, GGT/AST, and the predictor variables used alone or in combination, and the area under the ROC curve (AUC), sensitivity, and specificity were calculated; the Z test was used for comparison of AUC. Results The HCC group had significantly higher GGT/AST ratio and AFP than the other groups (all P < 0.05). The ROC curve analysis showed that AFP combined with GGT/AST ratio had a significantly higher AUC than AFP alone in the HCC group vs the LC group, the HCC group vs the HC+CHB+LC groups, and the HCC group vs the CHB+LC groups ( Z =2.684, 2.241, and 2.415, P =0.007, 0.025, and 0.016). Conclusion AFP combined with GGT/AST ratio can improve the clinical diagnostic performance of HBV-related HCC and thus has a certain diagnostic value.

8.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 339-343, 2020.
Article in Chinese | WPRIM | ID: wpr-799764

ABSTRACT

Objective@#To compare the efficacy of laparoscopic choledochoscopic cholelithotripsy and laparoscopic cholecystectomy in the treatment of cholecystolithiasis.@*Methods@#A retrospective study was conducted in 81 cases of cholecystolithiasis who admitted to the People's Hospital of Yuci District from March 2013 to March 2018.The patients were divided into control group (n=38, laparoscopic cholecystectomy) and study group (n=43, laparoscopic choledochoscope choledocholithotomy) according to the different surgical method.The perioperative indicators, liver function indicators, recurrence rate and complications were compared between the two groups.@*Results@#The operation time, hospital stay, recovery time of gastrointestinal function, recovery time of diet after operation and intraoperative bleeding volume in the study group were (43.59±4.59)min, (7.24±1.17)d, (15.51±2.09)d, (2.88±0.42)d, (15.07±1.32)mL, respectively, which were better than those in the control group [(55.23±5.47)min, (9.12±1.32)d, (26.48±3.48)d, (3.53±0.58)d, (24.65±1.48)mL] (t=10.411, 6.796, 17.426, 5.823, 6.864, all P=0.000). The levels of total bilirubin (TBIL), alanine transferase (ALT), aspartate aminotransferase (AST) and total protein (TP) at 1 day after operation in the study group were (24.39±2.21)μmol/L, (29.09±4.68)U/L, (29.02±4.41)U/L, (21.95±2.52)g/L, respectively, which were lower than those in the control group [(28.43±2.31)μmol/L, (34.39±4.28)U/L, (35.31±3.08)U/L, (25.28±2.42)g/L] (t=8.038, 5.293, 7.348, 6.046, all P=0.000). TBIL, ALT, ALT, AST, AST, TP levels at 3 days after surgery in the study group were (20.32±2.24)μmol/L, (24.61±4.26)U/L, (23.68±4.79)U/L, (18.94±2.89)g/L, respectively, which were lower than those in the control group [(24.45±2.02)μmol/L, (29.81±3.32)U/L, (27.94±4.50)U/L, (21.41±2.87)g/L] (t=8.669, 6.609, 4.109, 3.851; all P=0.000). The recurrence rates of the control group and the study group were 5.26% (2/38) and 6.98% (3/43), respectively, there was no statistically significant difference between the two groups (χ2=0.102, P=0.749). The incidence of complications in the study group was 4.65% (2/43), which was lower than 21.05% (8/38) in the control group, the difference was statistically significant (χ2=5.015, P=0.025).@*Conclusion@#Compared with laparoscopic cholecystectomy, laparoscopic assisted choledochoscopic choledocholithotomy has better curative effect, it can reduce the damage to liver function, with low incidence of complications, and it has high clinical value.

9.
Korean Journal of Gastroenterology ; : 205-211, 2019.
Article in English | WPRIM | ID: wpr-761557

ABSTRACT

BACKGROUND/AIMS: The serum aminotransferase level is usually elevated in rhabdomyolysis, and these enzymes originate from the skeletal muscle. On the other hand, there is limited data showing whether the degree of elevation of these enzymes differs according to the concurrent liver disease. METHODS: Patients with rhabdomyolysis were selected when their serum creatinine kinase level was >1,000 U/L. They were categorized as the group with and without concurrent liver disease. The AST and ALT levels in both groups were compared. In addition, the aminotransferase level was compared between those with rhabdomyolysis and those with alcoholic liver disease. RESULTS: Among the 165 patients with rhabdomyolysis, 19 had concurrent liver disease. The median peak AST was higher in the group with concurrent liver disease (332 U/L [interquartile range (IQR), 127–1,604] vs. 219 U/L [IQR, 115–504]). In addition, the median peak ALT was higher in the group with concurrent liver disease (107 U/L [IQR, 74–418] vs. 101 U/L [IQR, 56–218]). On the other hand, there was no significant difference in both enzymes between the two groups. The median peak AST level was significantly higher in those with rhabdomyolysis than in those with alcoholic liver disease (221 U/L [IQR, 118–553] vs. 103 U/L [IQR, 59–206]), but the median peak ALT was not significantly different (102 U/L [IQR, 58–222] vs. 51 U/L [IQR, 26–117]). CONCLUSIONS: Rhabdomyolysis showed an elevated AST-dominant aminotransferase level, which is not different according to concurrent liver disease. Therefore, it is recommended that rhabdomyolysis be considered first in cases of elevated aminotransferase levels in patients with a suspicious skeletal muscle injury.


Subject(s)
Humans , Alanine Transaminase , Aspartate Aminotransferases , Creatinine , Hand , Liver Diseases , Liver Diseases, Alcoholic , Liver , Muscle, Skeletal , Phosphotransferases , Rhabdomyolysis
10.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1578-1581, 2019.
Article in Chinese | WPRIM | ID: wpr-802593

ABSTRACT

Objective@#To investigate the expression and significance of Golgi protein 73 (GP73) in alcoholic cirrhosis.@*Methods@#From March 2015 to August 2017, 163 patients with alcoholic liver disease in the No.541 General Hospital were selected, including 51 patients with alcoholic fatty liver, 62 patients with alcoholic hepatitis, 50 patients with alcoholic liver cirrhosis, and 70 healthy volunteers were selected as control group.The liver function and the level of GP73 were detected.@*Results@#The GP73 level in the alcoholic liver cirrhosis group was (210.16±40.11)ng/mL, which was higher than that of the control group[(46.24±12.24)ng/mL], alcoholic fatty liver group [(85.10±20.43)ng/mL] and alcoholic hepatitis group[(160.18±32.05)ng/mL] (t=15.822, 30.022, 23.212, all P<0.05). GP73 was positively correlated with Gamma glutamyl transferase (GGT) (r=0.563, P<0.05), negatively correlated with albumin (Alb) (r=-0.488, P<0.05), and had no correlation with alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and total bilirubin (TBIL) (P>0.05). After treatment, the GP73 levels of effective patients in the alcoholic fatty liver group, alcoholic hepatitis group and alcoholic liver cirrhosis group were (54.16±11.18)ng/mL, (104.11±28.46)ng/mL, (122.03±30.54)ng/mL, respectively, which were lower than that of the ineffective patients (t=-4.600, -5.081 and -4.100, all P<0.05).@*Conclusion@#The GP73 level is significantly elevated in alcoholic liver disease.In alcoholic cirrhosis, GP73 level is the highest, has a certain relationship with the liver function index GGT, Alb and the therapeutic effect.

11.
The Korean Journal of Gastroenterology ; : 205-211, 2019.
Article in English | WPRIM | ID: wpr-787205

ABSTRACT

BACKGROUND/AIMS: The serum aminotransferase level is usually elevated in rhabdomyolysis, and these enzymes originate from the skeletal muscle. On the other hand, there is limited data showing whether the degree of elevation of these enzymes differs according to the concurrent liver disease.METHODS: Patients with rhabdomyolysis were selected when their serum creatinine kinase level was >1,000 U/L. They were categorized as the group with and without concurrent liver disease. The AST and ALT levels in both groups were compared. In addition, the aminotransferase level was compared between those with rhabdomyolysis and those with alcoholic liver disease.RESULTS: Among the 165 patients with rhabdomyolysis, 19 had concurrent liver disease. The median peak AST was higher in the group with concurrent liver disease (332 U/L [interquartile range (IQR), 127–1,604] vs. 219 U/L [IQR, 115–504]). In addition, the median peak ALT was higher in the group with concurrent liver disease (107 U/L [IQR, 74–418] vs. 101 U/L [IQR, 56–218]). On the other hand, there was no significant difference in both enzymes between the two groups. The median peak AST level was significantly higher in those with rhabdomyolysis than in those with alcoholic liver disease (221 U/L [IQR, 118–553] vs. 103 U/L [IQR, 59–206]), but the median peak ALT was not significantly different (102 U/L [IQR, 58–222] vs. 51 U/L [IQR, 26–117]).CONCLUSIONS: Rhabdomyolysis showed an elevated AST-dominant aminotransferase level, which is not different according to concurrent liver disease. Therefore, it is recommended that rhabdomyolysis be considered first in cases of elevated aminotransferase levels in patients with a suspicious skeletal muscle injury.


Subject(s)
Humans , Alanine Transaminase , Aspartate Aminotransferases , Creatinine , Hand , Liver Diseases , Liver Diseases, Alcoholic , Liver , Muscle, Skeletal , Phosphotransferases , Rhabdomyolysis
12.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1578-1581, 2019.
Article in Chinese | WPRIM | ID: wpr-753644

ABSTRACT

Objective To investigate the expression and significance of Golgi protein 73 (GP73) in alcoholic cirrhosis.Methods From March 2015 to August 2017,163 patients with alcoholic liver disease in the No.541 General Hospital were selected,including 51 patients with alcoholic fatty liver,62 patients with alcoholic hepatitis,50 patients with alcoholic liver cirrhosis,and 70 healthy volunteers were selected as control group.The liver function and the level of GP73 were detected.Results The GP73 level in the alcoholic liver cirrhosis group was (210.16 ± 40.11)ng/mL,which was higher than that of the control group [(46.24 ± 12.24) ng/mL],alcoholic fatty liver group [(85.10 ± 20.43) ng/mL] and alcoholic hepatitis group[(160.18 ± 32.05) ng/mL] (t =15.822,30.022,23.212,all P < 0.05).GP73 was positively correlated with Gamma glutamyl transferase (GGT) (r =0.563,P < 0.05),negatively correlated with albumin (Alb) (r =-0.488,P < 0.05),and had no correlation with alanine aminotransferase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP) and total bilirubin (TBIL)(P > 0.05).After treatment,the GP73 levels of effective patients in the alcoholic fatty liver group,alcoholic hepatitis group and alcoholic liver cirrhosis group were (54.16 ± 11.18)ng/mL,(104.11 ± 28.46)ng/mL,(122.03 ±30.54)ng/mL,respectively,which were lower than that of the ineffective patients (t =-4.600,-5.081 and -4.100,all P < 0.05).Conclusion The GP73 level is significantly elevated in alcoholic liver disease.In alcoholic cirrhosis,GP73 level is the highest,has a certain relationship with the liver function index GGT,Alb and the therapeutic effect.

13.
Acta cir. bras ; 34(6): e201900607, 2019. tab, graf
Article in English | LILACS | ID: biblio-1019264

ABSTRACT

Abstract Purpose Coleus forskohlii Briq., a medicinal plant originally from India, has been indicated against heart disease, expiratory disorders, convulsions, and hepatic changes, among others. In view of the broad pharmacological potential of the plant and the scarce information about its effects, the objective of the present study was to investigate the effect of its use for pretreatment of partially hepatectomized rats. Methods The animals were divided into two experimental groups: Control (CG) receiving physiological saline for 10 days before partial hepatetctomy, and Treated (TG) receiving 40 mg Coleus forskohlii/kg/day for 10 days before partial hepatectomy. The treatments were performed by gastric gavage. After the surgical procedure, treatment was continued according to the following groups: CG 24 h, CG 48 h, TG 24 h, and TG 48 hs, and liver tissue and intracardiac blood samples were obtained for histological and biochemical analysis, respectively. Results No significant differences were observed in mitotic or apoptotic index or in the concentrations of the enzymes AST, ALT and alkaline phosphatase, and no areas of fibrosis were detected. Conclusion Treatment with Coleus forskohlii did not interfere with the course of hepatic hyperplasia.


Subject(s)
Animals , Male , Rats , Plant Extracts/administration & dosage , Plectranthus/chemistry , Hepatectomy/methods , Liver/pathology , Aspartate Aminotransferases/blood , Biomarkers/blood , Hepatocytes/drug effects , Alanine Transaminase/blood , Alkaline Phosphatase/blood , Hyperplasia/drug therapy , Liver/surgery , Liver/drug effects
14.
J. Bras. Patol. Med. Lab. (Online) ; 54(5): 273-278, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-975852

ABSTRACT

ABSTRACT INTRODUCTION: Dengue virus (DENV) infection has been considered a major public health problem in tropical countries. The unavailability of serologic testing in public health centers might adversely impact patients' outcome. OBJECTIVE: This study aimed to evaluate the accuracy of mean platelet volume (MPV) and aspartate aminotransferase (AST) to platelet ratio index (APRI) as laboratory markers of DENV infection that could be used to differentiate primary and secondary infections. METHODS: We assessed laboratory results from 503 patients with positive rapid test for DENV infection. RESULTS: Severe thrombocytopenia and increased liver involvement were observed in patients with DENV heterotypic secondary infection. Our data suggest that APRI was able to distinguish patients with primary and secondary infection (p = 0.006) with a relevant sensitivity (75%), specificity (76%) and a cut-off of 1.06. A total of 80 out of 105 (76%) patients with primary DENV infection had APRI ≤ 1.06, and 12 (75%) with secondary DENV infection had APRI > 1.06. On the other hand, MPV did not show significance in the differentiation of types of infection, coming up with poor area under the receiver operating characteristic (ROC) curve (0.61). CONCLUSION: APRI seems to be a powerful tool for early identification of DENV secondary infection cases in health centers.


RESUMO INTRODUÇÃO: A infecção pelo vírus da dengue (DENV) é considerada um grande problema de saúde pública nos países tropicais. A indisponibilidade de testes sorológicos em centros de saúde pública pode afetar negativamente o prognóstico do paciente. OBJETIVO: Este estudo teve como objetivo avaliar a precisão do volume médio de plaquetas (MPV) e o índice da relação de aspartato aminotransferase (AST) sobre plaquetas (APRI) como marcadores laboratoriais de infecção por DENV, que poderiam ser utilizados para diferenciar infecções primárias e secundárias. MÉTODOS: Foram avaliados os resultados laboratoriais de 503 pacientes com teste rápido positivo para infecção por DENV. RESULTADOS: Foram observadas trombocitopenia grave e disfunção hepática em pacientes com infecção secundária heterogênea por DENV. Nossos dados sugerem que o APRI foi capaz de distinguir os pacientes com infecção primária e secundária (p = 0, 006), com relevante sensibilidade (75%) e especificidade (76%) e corte de 1, 06. Um total de 80 de 105 (76%) pacientes com infecção primária por DENV tinha APRI ≤ 1, 06; e 12 (75%) com infecção secundária por DENV, APRI > 1, 06. Por outro lado, o MPV não mostrou significância na diferenciação de tipos de infecção, apresentando baixo valor da área sob a curva de característica de operação do receptor (ROC) (0, 61). CONCLUSÃO: APRI parece ser uma ferramenta poderosa para identificação precoce de casos de infecção secundária de DENV em centros de saúde.

15.
Acta cir. bras ; 33(5): 439-445, May 2018. graf
Article in English | LILACS | ID: biblio-949344

ABSTRACT

Abstract Purpose: To investigate the effects of capsiate treatment on hepatic hyperplasia in partially hepatectomized rats. Methods: The animals were divided into a Capsiate group (CPH), a Capsiate Post-Partial Hepatectomy group (CPPH) and a Partial Hepatectomy Control group (PH). CPH and CPPH animals received 60 mg/kg/day Capsiate for 30 days. Next, the rats underwent partial hepatectomy. CPPH animals continued to receive treatment for 48 h after partial hepatectomy. Liver tissue and intracardiac blood samples were obtained 24 or 48 h after PH. Results: Capsiate treatment interfered with hepatic parameters, reducing the number of mitoses and apoptosis and increasing blood ALT and alkaline phosphatase concentrations. Conclusion: Capsiate treatment preceding hepatic surgery may compromise the initial period of postoperative recovery.


Subject(s)
Animals , Male , Rats , Capsaicin/analogs & derivatives , Hepatectomy , Liver/enzymology , Aspartate Aminotransferases/metabolism , Capsaicin/pharmacology , Rats, Wistar , Apoptosis/drug effects , Alanine Transaminase/metabolism , Alkaline Phosphatase/metabolism , Liver/drug effects , Liver/pathology , Liver Regeneration/drug effects , Mitosis/drug effects
16.
Journal of Veterinary Science ; : 500-504, 2018.
Article in English | WPRIM | ID: wpr-758835

ABSTRACT

We studied the toxic effects of a Sarcocystis hirsuta cyst extract fed to mice. Degenerative changes were found in mice gavage-fed fresh, frozen, and heat-treated S. hirsuta cyst extract. There were increases in the levels of serum aspartate aminotransferase and alanine aminotransferase as well as hepatic and brain malondialdehyde (MDA) levels along with concomitant decreases in catalase (CAT) and superoxide dismutase (SOD) activities of mice receiving fresh and frozen S. hirsuta extracts. Gavage feeding of heat-treated S. hirsuta cyst extract had no effects on liver enzymes or brain MDA content, but the liver MDA level did increase. Mice in the heat-treated cyst group showed reduced CAT and SOD activities as well as increased hepatic MDA levels compared to those in the control group. These results indicate that an extract of S. hirsuta cyst can induce oxidative stress and hepatic injury, even after heat treatment.


Subject(s)
Animals , Cats , Mice , Alanine Transaminase , Aspartate Aminotransferases , Brain , Catalase , Hot Temperature , Liver , Malondialdehyde , Oxidative Stress , Sarcocystis , Superoxide Dismutase
17.
Acta cir. bras ; 32(3): 194-202, Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-837694

ABSTRACT

Abstract Purpose: To investigate the effects of lycopene and resveratrol pretreatment on hepatic hyperplasia in partially hepatectomized rats. Methods: The lycopene group and the resveratrol group received 40 mg/kg/day of lycopene or resveratrol, respectively (dissolved in olive oil or in saline solution, respectively) and administered via a gastric tube for 30 days. The partially hepatectomzed (PH) control groups received saline or olive oil via a gastric tube for 30 days, respectively, and the normal control group received no treatment. Liver tissue and intracardiac blood samples were obtained 24, 36 or 48 h after PH. Results: No areas of fibrosis were detected. No significant changes in mitotic index, in the number of apoptosis events or in aspartate aminotransferase and alanine aminotransferase levels were observed. Conclusions: Lycopene and resveratrol pretreatment did not interfere on hepatic hyperplasia in partially hepatectomized rats.


Subject(s)
Animals , Male , Stilbenes/pharmacology , Carotenoids/pharmacology , Hepatectomy/methods , Liver/surgery , Liver/drug effects , Antioxidants/pharmacology , Aspartate Aminotransferases/blood , Time Factors , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Apoptosis/drug effects , Oxidative Stress/drug effects , Alanine Transaminase/blood , Liver/enzymology , Liver/pathology , Liver Regeneration/drug effects , Mitotic Index
18.
Journal of Clinical Hepatology ; (12): 1096-1100, 2017.
Article in Chinese | WPRIM | ID: wpr-613372

ABSTRACT

Objective To investigate the feasibility of alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio in predicting the degree of hepatic steatosis in chronic hepatitis C (CHC) patients.Methods A total of 231 CHC patients who visited The First People's Hospital of Nanyang from May 2012 to June 2016 were enrolled,among whom 105 (45.45%) had nonalcoholic fatty liver disease (NAFLD) and 126 (54.55%) did not have NAFLD.According to the ultrasound score,the NAFLD group was divided into mild-to-moderate (1-2 points) hepatic steatosis group (n =67) and severe (3 points) hepatic steatosis group (n =38).The two groups were compared in terms of demographic data and disease data including creatinine,fasting blood glucose,ALT,AST,ALT/AST ratio,γ-glutamyltransferase (GGT),uric acid,low-density lipoprotein,high-density lipoprotein (HDL),cholesterol (CHO),and triglyceride (TG) to screen out independent risk factors for NAFLD in CHC patients.The independent samples t-test was used for comparison of normally distributed continuous data between groups,and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical data between groups;with severe NAFLD as the dependent variable,different factors were introduced into the logistic regression equation to screen out independent risk factors.Results Compared with the non-NAFLD group,the NAFLD group had significantly higher systolic pressure,diastolic pressure,fasting blood glucose,ALT/AST ratio,and levels of ALT,GGT,HDL,CHO,and TG,as well as a significantly higher proportion of patients with diabetes,hypertension,or metabolic syndrome (all P < 0.05).Compared with the severe hepatic steatosis group,the mild-to-moderate hepatic steatosis group had significantly lower systolic pressure,diastolic pressure,fasting blood glucose,ALT/AST ratio,and levels of ALT,GGT,HDL,CHO,and TG,as well as a significantly lower proportion of patients with diabetes,hypertension,or metabolic syndrome (all P < 0.05).The logistic regression analysis showed that metabohc syndrome,ALT,and ALT/AST ratio were independent risk factors for NAFLD (all P <0.05),and metabolic syndrome,ALT,ALT/AST ratio,and GGT were independent risk factors for severe NAFLD (all P < 0.05).Conclusion ALT/AST ratio is an independent risk factor for NAFLD in CHC patients and has a certain value in evaluating the degree of NAFLD.

19.
Chongqing Medicine ; (36): 1217-1219, 2017.
Article in Chinese | WPRIM | ID: wpr-514416

ABSTRACT

Objective To investigate the value of detection of serum LDH,AST,CK and LDH and TNF-α of CSF in the acute phase of adult intracranial infection.Methods Seventy-seven patients with acute stage of intracranial infection in our hospital from January 2014 to December 2015 were selected as the observation group,and 60 patients with non-infectious nervous system diseases were selected as the control group.The levels of serum LDH,AST and CK,and LDH and TNF-α levels of CSF within 7 d after onset were compared between the two groups and the subgroup analysis was performed.Results The levels of serum LDH,AST and CK,and TNF-α and LDH of CSF in the infection group were significantly higher than those in the control group,the difference was statistically significant (P<0.05);LDH level of CSF in the purulent meningitis and tuberculous meningitis groups was significantly higher than that in the viral encephalitis group (P<0.05);the level of TNF-α of CSF in the purulent meningitis was significantly higher than that in the tuberculous meningitis and viral meningitis groups (P<0.05).Conclsion Detecting serum LDH,AST and CK,and LDH and TNF-α levels of CSF is conducive to the auxiliary diagnosis of intracranial infection,meanwhile has a certain discriminating value for the causes of intracranial infection.

20.
Journal of Preventive Medicine and Public Health ; : 377-385, 2017.
Article in English | WPRIM | ID: wpr-196773

ABSTRACT

OBJECTIVES: Although mercury (Hg) exposure is known to be neurotoxic in humans, its effects on liver function have been less often reported. The aim of this study was to investigate whether total Hg exposure in Korean adults was associated with elevated serum levels of the liver enzymes aspartate aminotransferase (AST), alanine transaminase (ALT), and gamma-glutamyltransferase (GGT). METHODS: We repeatedly examined the levels of total Hg and liver enzymes in the blood of 508 adults during 2010-2011 and 2014-2015. Cross-sectional associations between levels of blood Hg and liver enzymes were analyzed using a generalized linear model, and nonlinear relationships were analyzed using a generalized additive mixed model. Generalized estimating equations were applied to examine longitudinal associations, considering the correlations of individuals measured repeatedly. RESULTS: GGT increased by 11.0% (95% confidence interval [CI], 4.5 to 18.0%) in women and 8.1% (95% CI, -0.5 to 17.4%) in men per doubling of Hg levels, but AST and ALT were not significantly associated with Hg in either men or women. In women who drank more than 2 or 3 times per week, AST, ALT, and GGT levels increased by 10.6% (95% CI, 4.2 to 17.5%), 7.7% (95% CI, 1.1 to 14.7%), and 37.5% (95% CI,15.2 to 64.3%) per doubling of Hg levels, respectively, showing an interaction between blood Hg levels and drinking. CONCLUSIONS: Hg exposure was associated with an elevated serum concentration of GGT. Especially in women who were frequent drinkers, AST, ALT, and GGT showed a significant increase, with a significant synergistic effect of Hg and alcohol consumption.


Subject(s)
Adult , Female , Humans , Male , Alanine Transaminase , Alcohol Drinking , Aspartate Aminotransferases , Drinking , gamma-Glutamyltransferase , Linear Models , Liver , Longitudinal Studies
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