Abnormální jaterní testy u dětí s vrozenými srdečními vadami – průřezová studie na jihovýchodě Íránu

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Autoři: I. Shahramian ¹ ; A. Bazi ² ; E. Akhlaghi ³ ; N. M. Noori ⁴ ; F. Parooie ⁵ ; M. Tahani ⁵
Působiště autorů: Pediatric ward, Amir-Al-Momenin Hospital, Zabol University of Medical Sciences, Zabol, Iran ¹; Faculty of Allied Medical Sciences, Zabol University of Medical Sciences, Zabol, Iran Iran ²; Student Research Committee, Zabol University of Medical Sciences, Zabol, Iran ³; Children and Adolescent Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences and Health Services, Zahedan, Iran ⁴; Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran ⁵
Vyšlo v časopise: Gastroent Hepatol 2022; 76(6): 485-491
Kategorie: Dětská gastroenterologie a hepatologie: přehledová práce
doi: https://doi.org/10.48095/ccgh2022485

Souhrn

Východiska: U dětí s vrozenými srdečními vadami (VSV) není klinický význam abnormálních jaterních testů dostatečně studován. Cílem naší studie byl screening jaterních testů u dětí s VSV. Metodika: U 80 dětí s VSV byly měřeny jaterní testy včetně jaterních enzymů (AST, ALT a ALP), přímého bilirubinu (DB), celkového bilirubinu a albuminu. Výsledky: Z našich pacientů mělo 45 (67,4 %) defekt komorového septa (VSD), 3 (3,8 %) Fallotovu tetralogii (TOF), 25 (20 %) defekt septa síní (ASD), 2 (2,5 %) městnavé srdeční selhání (CHF) a 5 (6,2 %) perzistující ductus arteriosus (PDA). U 3 pacientů (3,8 %) bylo nalezeno abnormálně zvýšené ALT, u 21 (26,2 %) AST, u 6 (7,6 %) ALP, u 10 (12,5 %) DB, u 7 (8,8 %) TB a u 43 (53,8 %) snížený celkový protein. Jednotlivé vrozené srdeční vady se v jaterních testech významně nelišily s výjimkou AST (p = 0,04). Průměrná hladina AST byla významně nižší u dětí s VSD (31,4 ± 10,7 IU/l) než u dětí s TOF (48,3 ± 22,8 IU/l; p = 0,03) a s ASD (36,8 ± 9,8 IU/l; p = 0,03). Závěr: Vzhledem k vysoké incidenci abnormálních jaterních testů u dětí s VSV je vhodné tyto hodnoty pravidelně monitorovat, aby se včas zvládla případná progrese do městnavé nebo ischemické hepatitidy.

Klíčová slova:

srdeční selhání – vrozená srdeční vada – defekt komorového septa – ischemická hepatitida

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