Ischemic hepatitis: influence factors and clinical features / 中华老年医学杂志

ABSTRACT

Objective To investigate the incidence,influencing factors and clinical features of ischemic hepatitis.Methods Changes of serum transaminase and lactate dehydrogenase in patients with shock and respiratory failure were recorded in our hospital.Ischemic hepatitis was identified according to diagnosis guidelines,and its incidence was counted.Clinical data of patients with ischemic hepatitis were recorded.Results There were 53 cases diagnosed as ischemic hepatitis in 317 severe patients,including hemorrhagic shock,heart failure,respiratory failure,et al.The incidence was high in elderly patients aged over 70 years and male.Levels of alanine aminotransferase (ALT),AST and lactic dehydrogenase (LDH) were significantly increased 1-3 days after shock and respiratory failure,then reached to peak value 1-5 days [averaged (3.35±0.89) days] after shock and respiratory failure.Serum ALT was 869-4354 U/L,AST was 773-4833U/L and LDH was 1021-2662 U/L.Total bilirubin level was increased in 16 cases and the total bilirubin was 14-54 μmol/L.AST was declined to a point within 2 times the upper limit of normal range after 9-16 days,averaged (13± 1.6) days.Elevated transaminase level had no correlation with sex,age and pre-existing liver diseases.The time of enzyme changes had no correlation with sex but age and liver diseases.Patients aged ≥ 70 years had later AST peak and the recovery time was longer than younger patients (P＜0.01).Conclusions Ischemic hepatitis occurs mainly in men and elderly people.But advanced age and underlying liver diseases can affect the recovery time of transaminase in patients with ischemic hepatitis.