慢性肾脏疾病患者血清转氨酶:基于医院的比较研究

A. Pokhrel, B. R. Pokhrel, Rachana Pandey, Pragya Malla, Bishesh Sah, Jharana Shrestha, M. Khanal
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摘要

血清转氨酶水平的测定对肝病的诊断和监测具有重要意义。研究表明,慢性肾脏疾病患者,特别是血液透析患者,血清转氨酶的参考范围可能不能反映肝功能。因此,这类患者的肝脏疾病的诊断和治疗变得相当具有挑战性。本研究旨在评估和比较血液透析患者和健康对照者血清转氨酶水平。在尼泊尔医学院教学医院接受血液透析治疗至少三个月的75例患者作为病例和过去三个月没有活动性疾病和定期用药的明显健康个体被纳入研究,并被招募为对照组。抽取透析前血液样本,分析血清转氨酶和其他血液参数。血透患者血清AST和ALT中位数分别为15 U/L和21 U/L,健康对照组为30 U/L和36 U/L,差异有统计学意义(p < 0.001)。血透患者血清AST与eGFR呈正相关(ρ = 0.247, p = 0.033),与血清肌酐水平负相关(ρ = -0.307, p = 0.007)。因此,与肾功能正常的患者相比,肾功能受损患者血清转氨酶水平较低。
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Serum Aminotransferases in Chronic Kidney Disease Patients: A Hospital based Comparative Study
Estimation of serum aminotransferase levels play important role in the diagnosis and monitoring of hepatic diseases. Studies suggest that in patients with chronic kidney disease, especially in those under hemodialysis, the reference ranges of the serum aminotransferases might not be reflective of hepatic function. Due to this, diagnosis and management of liver diseases in such patients becomes quite challenging. This study aims to estimate and compare serum aminotransferases levels of hemodialysis patients and healthy controls. Seventy-five patients undergoing hemodialysis in Nepal Medical College Teaching Hospital for at least three months were included in the study as cases and apparently healthy individuals with no active illness and regular medication use for the past three months and were recruited as controls. Predialysis blood samples were drawn and were analyzed for serum aminotransferases and other blood parameters. The median serum AST and ALT values for hemodialysis patients were 15 U/L and 21 U/L, while for the healthy controls, it was 30 U/L and 36 U/L and the differences were statistically significant (p < 0.001). Among the hemodialysis patients, serum AST was positively correlated with eGFR (ρ = 0.247, p = 0.033) and negatively correlated with serum creatinine levels (ρ = -0.307, p = 0.007). Hence, serum aminotransferases levels were found to be low in patients with impaired kidney function compared to those with normal kidney function.
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