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目的了解瑞安市高三学生高考体检谷丙转氨酶(ALT)异常的原因,为有效防控高三年级学生肝功能异常提供依据。方法选取参加2014年和2015年瑞安市高考体检的学生(男生6 734名,女生6 216名),空腹检测肘静脉血谷丙转氨酶。随机选取100名ALT≥80 U/L的学生为异常组,150名健康学生(ALT<40 U/L)为对照组,对其进行进一步检测可能相关指标,同时发放问卷调查学生相关信息。结果 ALT异常占总体检人数的1.07%(139/12 950),ALT异常组性别构成(男生占88%,女生占12%)与对照组(男生占56%,女生占44%)差异有统计学意义(χ2=28.62,P<0.01)。单因素分析显示,ALT异常组与对照组比较,BMI,SUA,AST,TG,TC,LDL、乙肝大三阳、饮食习惯、睡眠时间、近期用药史差异均有统计学意义(P值均<0.01);多因素Logistic回归分析显示,肝胆疾病史、TG、饮食习惯、LDL、BMI、SUA为ALT异常的危险因素(OR值分别为36.15,8.80,4.35,3.03,1.42,1.02)。在调整其他因素影响的条件下,低脂饮食与合理搭配饮食比较,前者患病的风险是后者的2.40和4.35倍;有肝胆疾病史与无肝胆疾病史比较,前者患病的风险是后者的36.15倍;BMI每增加1个单位,患病风险增加1.42倍。结论瑞安市高三学生高考体检谷丙转氨酶异常与多种因素有关。应加大相关知识的宣传,以降低学生ALT异常率。
Objective To understand the reasons for the abnormalities of alanine aminotransferase (ALT) in college entrance examination of senior high school students in Ruian City, and to provide basis for preventing and controlling the abnormal liver function of high third grade students effectively. Methods A total of 6 734 boys and 6 216 girls were enrolled in the physical examination of entrance exams in Ruian city in 2014 and 2015. The level of alanine aminotransferase (ALT) in the elbow vein was measured on an empty stomach. A total of 100 students with ALT≥80 U / L were randomly selected as the abnormal group and 150 healthy students (ALT <40 U / L) as the control group, which were further tested for possible related indicators and questionnaires were also sent to students. Results The abnormality of ALT accounted for 1.07% of the total (139/12 950). There were statistically significant differences in gender composition (88% for boys and 12% for girls) and controls (56% for boys and 44% for girls) Significance (χ2 = 28.62, P <0.01). Univariate analysis showed that there were significant differences in BMI, SUA, AST, TG, TC, LDL, HBeAg, dietary habits, sleep time and recent medication history between ALT abnormal group and control group (P < 0.01). Multivariate logistic regression analysis showed that the history of hepatobiliary disease, TG, diet, LDL, BMI and SUA were the risk factors of abnormal ALT (OR = 36.15, 8.80, 4.35, 3.03, 1.42, 1.02 respectively). In the adjustment of other factors, the low fat diet compared with a reasonable diet, the former is 2.40 and 4.35 times the risk of the latter; have a history of hepatobiliary disease and no history of hepatobiliary disease, the risk of the former is the latter Who were 36.15 times; BMI increased by 1 unit, the risk of increased 1.42 times. Conclusions The abnormalities of alanine aminotransferase in college entrance examination of senior high school students in Ruian City are related to many factors. Should increase the publicity of relevant knowledge, in order to reduce the student ALT abnormal rate.