肺炎伴血清丙氨酸转氨酶升高患儿的临床特征分析

摘要

Objectives To investigate the clinical features of pneumonia in children with elevated alanine aminotransferase(ALT). Methods Clinical and laboratory data of 3 979 children with pneumonia admitted to the hospital were collected and retrospectively analysed, and ALT was detected in all cases. Results In 3 979 children with pneumo-nia, elevated ALT (13.78%) was found in 548 cases, most of which had mildly elevated ALT and were infants less than 6 months. The average age in elevated ALT group was less than that in normal ALT group (P=0.000). Apart from the symp-toms of pneumonia, most of them had non-specific clinical symptoms, 169 cases (30.84%) with anorexia or feeding dif-ficulties. 22 cases (4.01%) with poor spirit or weak, 10 cases (1.82%) with crying or abdominal pain;6 cases (1.09%) with dark urine; 4 cases (0.73%) with skin and/or sclera jaundice, 2 cases (0.36%) with bleeding tendency. Children in mildly elevated ALT group recovered faster than in moderate-to-severe elevated ALT group. Conclusions Mildly elevated ALT was most common in pneumonia with elevated ALT which was more likely to occur in younger age group. Clinical mani-festations were often non-specific with good outcomes.%　　目的探讨肺炎伴血清丙氨酸转氨酶（ALT）升高患儿的临床特点。方法回顾性分析住院治疗的3979例肺炎患儿的临床和ALT及其他实验室资料。结果3979例肺炎患儿中548例伴ALT升高(13.78%)，以轻度升高为主，以<6个月小婴儿多见。ALT升高组的平均年龄小于ALT正常组，差异有统计学意义（P=0.000）。ALT升高肺炎患儿除肺炎的临床症状外，大多无特异性临床症状，部分有纳差/喂哺困难169例（30.84%），少数伴精神欠佳/乏力22例（4.01%）、哭闹/腹痛10例（1.82%）、尿黄6例（1.09%）、皮肤和（或）巩膜黄染4例（0.73%）、出血倾向2例（0.36%）。ALT轻度升高组较ALT中重度升高组恢复更快。结论肺炎伴ALT升高以轻度升高多见，更易发生在小婴儿，临床表现无特异性，预后均良好。