The Liver in Shock Patients: A Clinical Study
Other Title
休克病人肝臟之臨床研究
Journal
Chinese journal of gastroenterology
Journal Volume
2
Journal Issue
4
Pages
177
Date Issued
1985-12-01
Author(s)
Ming-Yang Lai
Juei-Low Sung
Abstract
Fifty one patients were reviewed to study the effect of shock on the liver. After shock, 29 cases (57%) had elevated alanine aminotransferase (SGPT) activities, 14 cases (28%) developed notable elevation greater than 5 times of upper normal limit. In most cases, asparate aminotransferase (SGOT) was greater than SGPT in the initial stage of shock. The presence of elevated SGPT was related to initial blood pressure following shock (P＜0.05), but not to the age, sex of the patients, or the cause or duration of shock. The extent of the enzyme elevation correlated poorly with any of the above factors. Serum alkaline phosphotase (ALP) activity was measured in 46 patients. Among them 29 (63%) were normal, 15 (33%) were 2 times of upper normal limit, and 2 (4%) were 3 times of upper normal limit. Serum bilirubin level was normal in 23 cases (45%), elevated to more than 3 times of upper normal limit in 15 cases (14%). The presence of hyperbilirubinemia showed correlation with elevation of SGPT and the cause of shock (P＜0.05). The hyperbilirubinemia was more frequently seen in patients with cardiogenic shock (7/9) or with septic shock (16/25) than with hypovolemic shock (3/11). Liver biopsies were available in 3 cases, showing central necrosis (zone 3 necrosis), zonal necrosis (zone 2-3 necrosis), and fatty metamorphosis respectively. Eighteen patients died, but none was attributed to liver failure. In the survived cases, elevated serum transaminase activity decreased rapidly to normal range within 2 weeks in 90% of them. In conclusion, the prevalence of shock liver is not rare. It results from hypo-perfusion of the liver, and is characterized by a sudden rise and rapid decrease of serum transaminase. The prognosis depends on the underlying disease.
Subjects
休克肝
肝功能檢查
Shock liver
liver function test
Publisher
中華民國消化系醫學會雜誌
Type
journal article