论文部分内容阅读
目的 研究正常范围的血清转氨酶浓度与肝病死亡率之间的关系。 方法 前瞻性队列研究 研究场所 韩国医疗保险公司,随访8年 研究对象94 533例男性和47 522例女性,年龄35～59岁。 主要结果评价 根据死亡证明所获得的肝脏疾病死亡率。 结果 转氨酶浓度与肝脏疾病的死亡率有正相关,甚至正常范围内(35～40IU/l)也是如此。与浓度<20IU/l相比,谷草转氨酶的浓度为20～29IU/l和30～39IU/l时,调整后的相对危险性分别为男性为2.5(95％可信区间2.0～3.0)和8.0(6.6～9.8),女性为3.3(1.7～6.4)和18.2(8.1～40.4)。谷丙转氨酶相应的危险性分别为男性为2.9(2.4～3.5)和9.5(7.9～11.5),女性为3.8(1.9～7.7)和6.6(1.5～25.6)。根据受试者工作特性曲线,对于男性来说,谷草转氨酶和谷丙转氨酶预测肝脏疾病的最佳临界点分别为31IU/l及30IU/l。 结论 对于转氨酶活性轻度升高但仍在正常范围者,应密切观察并进一步进行肝脏疾病的检查。
Objective To investigate the relationship between normal serum transaminase concentration and liver mortality. Methods Prospective cohort Study Place Korea Medical Insurance Company, 94 533 males and 47 522 females, aged 35-59 years, followed up for 8 years. Main Outcomes Assess liver disease mortality rates based on death certificates. Results There was a positive correlation between aminotransferase concentration and mortality from liver disease, even within the normal range (35-40 IU / l). The relative adjusted odds ratios for aspartate aminotransferase at 20 to 29 IU / l and 30 to 39 IU / l were 2.5 (95% confidence interval, 2.0 to 3.0) and 8.0 (6.6-9.8) for women and 3.3 (1.7-6.4) and 18.2 (8.1-40.4) for women. The corresponding risk for alanine aminotransferase was 2.9 (2.4-3.5) and 9.5 (7.9-11.5) for men, 3.8 (1.9-7.7) and 6.6 (1.5-25.6) for women. According to the working characteristic curve of the subjects, the best cut-off point of aspartate aminotransferase and alanine aminotransferase for predicting liver diseases were 31 IU / l and 30 IU / l for men respectively. Conclusion For patients with slight increase in transaminase activity but still in the normal range, the liver disease should be closely observed and further examined.