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| 題 名 | Liver Function in Patients with Vitamin K Deficiency in Infancy=嬰兒維他命K缺乏症之肝機能 |
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| 作 者 | 林明燦; 曹龍彥; 沈銘鏡; | 書刊名 | 中華民國小兒科醫學會雜誌 |
| 卷 期 | 35:6 民83.11-12 |
| 頁 次 | 頁514-521 |
| 分類號 | 417.5914 |
| 關鍵詞 | 嬰兒維他命K缺乏症; 肝機能異常; 維他命K預防; Vitamin K deficiency in infancy; Liver function impairment; Vitamin K prophylaxis; |
| 語 文 | 英文(English) |
| 中文摘要 | 本文研究維他命K缺乏症嬰兒肝功能的變化。十五個病例中有兩例爲牛奶哺育,其餘均只吃母乳,有四例在出生時曾接受維他命K注射。長期觀察中發現大多數病人均有肝功能異常,發病時有六例肝氨基轉化酶昇高,另六例在發病數週後才有肝氨斟轉化酶增加現象,有六例在發病時發現有膽汁滯積的現象,另有兩例在出血數週後才發生膽汗滯積,而不論有無肝氨基轉化酶的昇高或者有無黃膽的存在,多數病人均有血清鹸性磷酸酶(ALP),或是丙麩氨轉肽酶(GGT)或是膽汁酸增加現象。所有病人異常的肝氨基轉化酶都在發病5週到23個月後恢複正常。本研究顯示維他命K缺乏的嬰兒均須長期追蹤肝機能的變化。而除了膽汁滯積可能引起他命K吸收不良外,肝功能異常在本症的發生上了可能扮演重要的角色,但確實的致病機轉及肝功能異常的原因仍不明白。本研究同時也發現即使出生時注射維他命K仍不能完全避免他命K缺乏症的發生,尤以對肝機能異常的病人,其預防效果更不確定。 |
| 英文摘要 | Liver chemistry was studied in fifteen patients with vitamin K deficiency in infancy (VKDI). All except 2 were exclusively breast fed and 4 of the 15 infants had received intramuscular vitamin K prophylaxis. A high incidence of hepatic dysfunction was found during long term follow-up in patients with VKDI. Abnormal aminotransferase was noted either at the time of onset (n=6) or during the ensuing few weeks (n=6). Cholestasis was documented in six cases at onset and another two in a later period. Most cases had increased serum alkaline phosphatase (ALP), y-glutamyl transferase (GGT), or bile acid levels regardless of hepatic enzymes and bilirubin levels. The abnormal enzymes returned to normal after 5 weeks to 23 months. This study demonstrates a close relationship between hepatic dysfunction and VKDI. Liver function impairment other than cholestasis may play some role in the patho genesis of VKDI, but the cause of hepatic dysfunction can not be defined. Follow-up of liver chemistry is recommended in patients with VKDI. Parenteral vitamin K prophylaxis at birth may not give sustained protection against VKDI, especially in those with underlying liver disease. |
本系統中英文摘要資訊取自各篇刊載內容。