镰状细胞病中与溶血相关的AST和ALT变化模式

IF 3 Q2 Medicine
K. Nsiah, V. Dzogbefia, Daniel Ansong, A. Akoto, H. Boateng, D. Ocloo
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引用次数: 25

摘要

背景:转氨酶水平升高通常与各种损伤引起的肝完整性受损有关。在镰状细胞病中,天冬氨酸转氨酶(AST)也通过血管内溶血释放。本研究是为了确定AST和丙氨酸转氨酶(ALT)的变化模式,特别是AST:ALT的比值,并将其与溶血状态联系起来,我们认为在一些镰状细胞病患者中,溶血状态比肝功能和心功能障碍更重要。方法测定330例镰状细胞病患者血清转氨酶、血红蛋白、网织红细胞和乳酸脱氢酶水平。选择AST:ALT比值作为溶血标志物,并将该比值与其他溶血标志物进行简单多元回归分析。结果AST、ALT平均水平分别为48.24%、27.78、26.48%、22.73 U/L。而在49例无镰状细胞病的受试者中,AST和ALT的平均水平相同,均为23.0 U/L。在镰状细胞病患者中,AST水平的升高远高于ALT水平,支持其通过血管内溶血释放。在95.8%的镰状细胞病患者中,谷丙转氨酶与谷丙转氨酶的比值为bb0.1,但我们的结果并未表明大多数患者存在明显的肝脏和心脏功能障碍。结论回归分析支持使用AST:ALT比值作为溶血标志物,因为它与血红蛋白水平呈负相关。无论处于稳定状态还是危重状态,只要肝和心脏的完整性未受到损害,镰状细胞病患者由于其溶血性,其AST水平均较高。这是第一个强调镰状细胞病中AST:ALT比值的报告。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pattern of AST and ALT changes in Relation to Hemolysis in sickle cell Disease
Background Elevated aminotransferase levels are commonly associated with compromised hepatic integrity from various insults. In sickle cell disease, aspartate transaminase (AST) is also released via intravascular hemolysis. This study was done to determine the pattern of changes in AST and alanine transaminase (ALT), in particular the AST:ALT ratio, and to relate these to the hemolytic state, which we consider to be more important than hepatic and cardiac dysfunction in some individuals with sickle cell disease. Methods Serum aminotransferase levels were measured in 330 subjects with sickle cell disease, as well as hemoglobin, reticulocytes, and lactate dehydrogenase. The AST:ALT ratio was designated as a hemolytic marker, and simple and multivariate regression analyses were carried out between this ratio and other hemolytic markers. Results Mean AST and ALT levels were 48.24 % 27.78 and 26.48 % 22.73 U/L, respectively. However, for 49 subjects without sickle cell disease, mean AST and ALT levels were the same, ie, 23.0 U/L. In the subjects with sickle cell disease, the increases in AST levels were far higher than for ALT, supporting its release via intravascular hemolysis. In 95.8% of the subjects with sickle cell disease, the AST:ALT ratio was > 1, but our results did not suggest overt malfunctioning of the liver and heart in the majority of subjects. Conclusion Regression analyses support the use of the AST:ALT ratio as a hemolytic marker, because it has an inverse association with the hemoglobin level. Whether in steady state or in crisis, provided hepatic and cardiac integrity has not been compromised, subjects with sickle cell disease would have higher AST levels due to the hemolytic nature of the condition. This is the first report highlighting the AST:ALT ratio in sickle cell disease.
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来源期刊
CiteScore
3.70
自引率
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