前瞻性研究显着的提高丙氨酸氨基转移酶的原因（ALT）

StephenW

Scandinavian Journal of Gastroenterology
   


A prospective study on the causes of notably raised alanine aminotransferase (ALT)

DOI:
    10.3109/00365521.2015.1121516

Helgi Kristinn Björnssona, Sigurdur Olafssonb, Ottar M. Bergmannb & Einar S. Björnssonab*
Publishing models and article dates explained

    Received: 18 Oct 2015
    Accepted: 15 Nov 2015
    Published online: 14 Dec 2015


Abstract

Objective
High levels of alanine aminotransferase (ALT) can be a marker of severe liver disease with variable aetiologies and prognosis. Very few prospective studies have been undertaken on the aetiology and prognosis of patients with high ALT levels. No population-based prospective study has systematically evaluated drug-induced liver injury (DILI) among these patients. The objective was to determine the aetiology and prognosis of patients with high ALT. Materials and methods In a catchment area of 160,000 inhabitants, a population-based prospective study identified all adult patients with serum level of ALT >500 U/L during a 12-month period. All underwent thorough diagnostic work-up and follow-up. In suspected DILI, causality was assessed with Roussel Uclaf Causality Assessment
Method.
Results A total of 155 patients were identified with ALT >500 U/L, 12 children and one with ALT of non-liver-related origin, leaving 142 patients for the analysis: 73 (51%) males, median age 52 (IQR 36–68, range 19–89 years). The most common causes were choledocholithiasis 48/142 (34%), ischaemic hepatitis 26 (18%), viral hepatitis 16 (11%) and DILI 15 (11%), hepatobiliary malignancy (n = 6), surgery/interventions (n = 8) and other aetiologies (n = 23). No specific aetiology was found in 6% of cases. In the total study cohort 99 (70%) required hospitalisation, 78 (55%) had jaundice and 22 (16%) died, liver-related death in 10%, 35% in IH and 7% in DILI.
Conclusions
The most common cause of notably high ALT was choledocholithiasis. Ischaemic hepatitis was a common aetiology with approximately 35% liver-related mortality. Viral hepatitis and DILI were important aetiologies among these patients.

StephenW

消化内科的斯堪的纳维亚杂志



的前瞻性研究显着的提高丙氨酸氨基转移酶的原因（ALT）

DOI：
    10.3109 / 00365521.2015.1121516

海尔吉KristinnBjörnssona，的Sigurdur Olafssonb，奥塔尔M. Bergmannb及埃纳尔·S.Björnssonab*
出版模式和文章日期解释

    收稿日期：2015年10月18日
    接受日期：2015年11月15号
    网上公布：二零一五年十二月十四日


抽象

目的
高水平的丙氨酸转氨酶（ALT）的可以是严重的肝脏疾病具有可变病因和预后的标记。很少前瞻性研究已经进行了对患者的高ALT水平的病因和预后。没有基于人群的前瞻性研究系统的评价药物性肝损伤（DILI）在这些患者。其目的是要确定的患者的高ALT的病因和预后。材料和方法在16万居民的流域面积，人口为基础的前瞻性研究发现在12个月内所有成年患者的ALT> 500 U / L的血清。所有接受全面的诊断工作和后续行动。在疑似DILI，因果关系与罗素优克福因果关系评估评估
方法。
结果共有155例患者确定了ALT> 500 U / L，12名儿童，一个是与非肝脏相关出身ALT，留下142例患者进行了分析：73（51％）的男性，平均年龄52（IQR 36 -68，范围19-89岁）。最常见的原因是胆总管结石一百四十二分之四十八（34％），缺血性肝炎26（18％），病毒性肝炎16（11％）和DILI 15（11％），肝胆恶性肿瘤（N = 6），手术/介入（N = 8）和其他病因（N = 23）。没有具体的病因学中发现案件的6％。在整个研究队列99（70％）需要住院治疗，78例（55％）有黄疸和22（16％）死亡，肝脏相关死亡的10％，35％IH和7％，在帝力。
结论
特别是高ALT最常见的原因是胆总管结石。缺血性肝炎是一种常见的病因有大约35％的肝脏相关的死亡率。病毒性肝炎和DILI是在这些患者的重要病因。