NGHIÊN CỨU ĐẶC ĐIỂM VÀ MỨC ĐỘ TỔN THƯƠNG TẾ BÀO GAN Ở BỆNH NHÂN SỐT XUẤT HUYẾT DENGUE NGƯỜI LỚN TẠI BỆNH VIỆN ĐA KHOA HOÀN MỸ CỬU LONG NĂM 2023

Abstract

Introduction: Dengue hemorrhagic fever is an infectious disease caused by the Dengue virus. Liver dysfunction is a common manifestation due to the direct effect of Dengue virus on liver cells or as a consequence of dysregulation of the immune response against Dengue virus. Elevated liver enzymes, such as aspartate transferase (AST) and alanine transferase (ALT) are indicative of liver function failure in Dengue hemorrhagic fever.
Objectives: Describe the characteristics and extent of liver cell damage in Dengue hemorrhagic fever adult patients at Hoan My Cuu Long General Hospital in 2023.
Methods: A cross-sectional, prospective descriptive study in Dengue hemorrhagic fever patients ≥ 16 years old. Liver cell damage is divided into 5 levels: Level 0 (no increase in liver enzymes), Level 1 (liver
enzymes increase < 5 times), Level 2 (liver enzymes increase 5 to < 10 times), Level 3 (liver enzymes increase ≥ 10 times), Level 4 (evidence of liver failure, liver-renal syndrome).

Results: From January 2023 to August 2023, 81 patients were studied. The average age was 34.08 ± 13.06 years old (16 - 83 years old), with 62.96% males and 37.04% females. Clinical features of the liver
included bleeding (37.04%), anorexia (11.11%), right upper quadrant pain (4.94%), hepatomegaly (2.47%), and no cases of mental disorders or jaundice. Median values of AST (U/L), ALT (U/L) by day of illness:
day 1 - 2 (46.84 and 39.74), day 3 - 4 (97.96 and 75.59), day 5 - 6 (163.60 and 109.06) and day 7 - 8 (131.59 and 110.96). Liver damage was categorized Level 1 (69.14%), Level 2 (13.58%), Level 3 (8.64%), Level
0 (8.64%) and level 4 (0.0%). The proportion of bleeding patients with Level 1 liver damage is higher than Level 2, Level 3 and Level 0 (73.33%; 23.33%; 10.0% and 3.33%), p = 0.620. The proportion of anorexia
patients with Level 1 liver damage is higher than Level 2 and Level 3 and Level 0 (66.67%; 22.22%; 11.11% and 0%), p = 0.679. The proportion of patients with mild, warning signs and severe Dengue hemorrhagic
fever with Level 1 liver damage (69.09%, 65.00% and 83.33%) is higher than Level 2 (14.55%, 15.00% and 0%), Level 3 (5.45%, 20.0% and 0%) and Level 0 (10.91%, 0% and 16.67%), p = 2.56.
Conclusions: Patients with Dengue hemorrhagic fever exhibited median AST and ALT values that gradually increase from days 1 - 2 to days 5 - 6, followed by a decrease from days 7 - 8 of the disease. Hepatocyte damage is mainly at Level 1. No correlation was found between clinical symptoms and the severity of the disease with the degree of liver cell damage.