摘要
目的:分析感染后肝功能损害患儿维生素D水平及其与丙氨酸氨基转移酶(alanine transarninase,ALT)的相关性。方法:采用ELISA测定105例呼吸道和消化道感染后肝功能损害患儿(年龄1~12个月)血清维生素D水平,根据患儿维生素D水平比较患儿保肝治疗前后ALT变化。结果:感染后肝功能损害患儿血清25-羟维生素D(25-hydroxyvitamin D,25-OHD)平均水平为(63±31)nmol/L,维生素D缺乏、不足和正常的比率为33.3%、41.9%、24.8%,与正常对照无差异(P>0.05)。维生素D缺乏和不足的肝功能损害患儿多表现为轻中度ALT升高;与维生素D正常的患儿相比,保肝治疗后患儿ALT水平仍偏高(P=0.07),而且ALT下降幅度显著低于维生素D正常的患儿(P<0.001)。患儿血清维生素D水平与保肝治疗后ALT水平呈负相关(r=-0.231,P=0.018),而与ALT下降幅度呈正相关(r=0.429,P<0.001)。结论:维生素D能促进感染后肝功能损害患儿ALT下降;纠正患儿维生素D缺乏或不足将有助于患儿肝细胞损伤的恢复。
Objective： To evaluate serum vitamin D status and its association with alanine transarninase（ALT） in children with impaired liver function after infection. Methods： Serum 25-hydroxyvitamin D（25-OHD） levels in 105 children with impaired liver function（aged 1-12 months old） were determined using ELISA. Before-and after-treatment ALT was compared based on 25-OHD status.Results： The mean 25-OHD level in children with impaired liver function was（63±31） nmol/L. The percentages of children with vitamin D deficiency, insufficiency, and sufficiency were 33.3%, 41.9%, and 24.8%, respectively, and there were no differences in comparison with the control group（all P〉0.05）. The vitamin D deficient and insufficient children tended to have mildly to moderately elevated ALT. However, they had a higher after-treatment ALT（P=0.07）. The ratios of decreased ALT over the basal ALT level in the vitamin D deficient and insufficient children were lower compared to those with the normal 25-OHD（P〈0.001）. The serum 25-OHD levels negatively correlated with the after-treatment ALT（R =-0.231, P =0.018） but positively with the ratio of decreased ALT over the basal ALT level（R=0.429, P〈0.001）. Conclusion： Vitamin D promotes the decrease of ALT in infants with impaired liver function after infection. Normalization of vitamin D levels may promote recovery of liver injury in those patients.
作者
蔡心怡
李靓雯
郑玉灿
张阳
阎坤龙
杨光
Cai Xinyi Li Jiangwen Zheng Yucan Zhang Yang Yan Kunlong Yang Guang(Department of Gastroenterology, Children＇s Hospital Affiliated to NJMU, Nanjing 210008, China)
出处
《南京医科大学学报（自然科学版）》
CSCD
北大核心
2017年第6期723-727,共5页
Journal of Nanjing Medical University(Natural Sciences)
基金
南京市医学科技发展重点项目(ZKX13039)
