NGHIÊN CỨU TỔN THƯƠNG GAN Ở BỆNH NHÂN SỐT XUẤT HUYẾT DENGUE Ở NGƯỜI LỚN

Abstract

Background: Liver damage is common in Dengue fever. Starting from asymptomatic elevated transaminase levels to acute liver failure, dengue has all the properties of a hepatic illness. Hepatic manifestations are either a result of direct viral toxicity or dysregulated immunologic injury in response to the virus or hepatocellular hypoxia.

Aims: 1. To evaluate the clinical liver damage, liver function tests in adult dengue patients and 2. To evaluate the relationship between liver damage and severity of disease.

Subjects and methods: Cross-sectional descriptive study. Studied on 160 adult Dengue patients admitted to the Department of Tropical Diseases, Hue Central Hospital, from April 2019 to June 2020.

Results: Among the clinical features of hepatic involvement, patients have abdominal pain (25%), hepatomegaly (6.3%), jaundice (1.3%), encephalopathy (0%). Raised AST and ALT levels: 2 - 5 folds (36.9% and 29.4%), 5 - 15 folds (16.9% and 11.9%), more than 15 folds (6.2% and 2,5%) and 90.6% of patients have the ratio AST/ALT > 1. AST and ALT levels increase during day 3 - 6 and tend to decrease after 3 days (p < 0,05). Raised ALP levels (1.3%), hyperbilirubinemia (2.5%), decrease PT% (6.9%). The values of AST, ALT, and total bilirubin are different between the levels of dengue, increased in the form of warning signs and severe dengue (p < 0.05). Transaminase levels increased correlated with other markers of disease severity, such as gastrointestinal bleeding, shock and the decrease of platelet cout. Other risk factors of shock in dengue infection: abdominal pain, hepatomegaly, decreased prothrombin ratio.

Conclusions: Transaminase levels correlated with disease severity, such as gastrointestinal bleeding, shock and the decrease of platelet cout. Other risk factors of shock in dengue infection: abdominal pain, hepatomegaly, decreased prothrombin ratio.