基于阿斯巴酸氨基转移酶的儿童肝损伤风险分层:开发一个简单的规则来预测不良结果
Xun Li1,2,3, Haipeng Yan4,5,6, Xiao Li4,5
1Pediatrics Research Institute of Hunan Province, Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China. li.xunxx@qq.com.
European journal of pediatrics
|July 12, 2025
概括
一项新规则使用亚斯巴酸氨基转移酶 (AST) 水平超过80 IU/L和其他肝功能测试可以识别患肝损伤高风险的儿童. 这种工具有助于对儿科肝病的快速风险分层.
科学领域:
- 儿科肝病学 儿科肝病学
- 生物标志物发现发现
- 临床风险分层的临床风险分层
背景情况:
- 酸氨基转移酶 (AST) 和氨基转移酶 (ALT) 是常见的肝损伤生物标志物,但缺乏预后价值.
- 升高的AST和ALT水平并不总是与疾病的严重程度或预后相关.
研究的目的:
- 开发一种简单的方法,将氨基转移酶与其他肝功能参数结合起来.
- 为了确定患有肝脏不良结果高风险的儿科患者.
主要方法:
- 分析了144,044名儿科患者的病历,得出了ALT和AST结果.
- 使用肝损伤标志物开发基于逻辑回归的预测规则 (ASTLI).
- 使用灵敏度和特异性指标验证规则.
主要成果:
- 80 IU/L的AST水平被确定为儿科患者风险增加的门.
- ASTLI规则包括AST> 80 IU/L以及总蛋白质/白蛋白,LDH或INR/PT中最多两种异常.
- 该规则在培训 (76%的敏感度,73%的特异性) 和验证 (76%的敏感度,79%的特异性) 两组都表现良好.
结论:
- 开发的分层规则可以作为儿童肝损伤的快速风险评估工具.
- ASTLI规则显示了在不同儿科群体中广泛适用的潜力.
相关概念视频
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
58
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
58
01:22Acute Kidney Injury I: Introduction
80
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
80