頁籤選單縮合
題名 | The Liver Biochemical Tests and Serological Markers of Hepatitis B Virus in the Very Old-Aged Population in Taiwan=臺灣地區高齡人口之肝生化學試驗及乙型肝炎病毒血清標記的變化 |
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作者 | 許春暉; 陳祖裕; 譚振熀; 林素華; 鄧光周; 李壽東; Hsu, Suen-hwei; Chan, Cho-yu; Tam, Tseng-nip; Lin, Shu-hwa; Tang, Kwong-chou; Lee, Shou-dong; |
期刊 | 中華醫學雜誌 |
出版日期 | 19960100 |
卷期 | 57:1 1996.01[民85.01] |
頁次 | 頁16-21 |
分類號 | 415.53 |
語文 | eng |
關鍵詞 | 乙型肝炎病毒; 肝生化試驗; 血清標誌; 非常高齡人口; Hepatitis B virus; Liver biochemical test; Serological markers; Very old-aged population; |
中文摘要 | 背景:老化伴隨人類肝臟功能許多改變。文獻報告,老人會有血清白蛋白下降及血清鹼性磷酸和膽固醇上昇情形。但並無報告強調非常高齡人口(>75歲)在這方面的變化,本研究在探討非常高齡人口之肝生化試驗及乙型肝炎病毒血清標誌的變化。 方法:自1993年10月至1994年6月,共有2,549人在本院接受健康檢查,去除影響肝生化試驗疾病者後,共有1,742名(男性1,058 人、女性684人)被列為肝生化試驗部分之研究對象。依受檢者年齡分為四組:年輕組(18至40歲,231人)、中年組(41至64歲,991人)、老年組(65至75歲,424人),非常老年組(>=76歲,96人),肝生化試驗包括血清白蛋白、膽紅素、膽固醇、氨基丙酸氨基轉移、天門冬酸氨基轉移、鹼性磷酸及伽瑪麩氨酸轉生。乙型肝炎病毒標誌盛行率部份,則以全部2,549人為研究族群,項目包括乙型肝炎病毒表面抗原(HBsAg)及乙型肝炎病毒表面抗體(anti-HBs)。 結果:所有肝生化學試驗中,血清白蛋白是唯一在老於75歲後仍持續下降的項目(p<0.05)。中年後之膽固醇有上昇傾向,但老於75 歲後則下降。四組在乙型肝炎病毒表面抗原之陽性率依序為年輕組16.8%、中年組12.3%、老年組6.8%及非常老年組7.0%。而四組在乙型肝炎病毒表面抗原及抗體均呈陰性之比率分別為23.4%、24.9%、26.7%及46.5%(p<0.001)。 結論:血清白蛋白是唯一在老於75歲後仍持續下降之肝生化試驗項目。而膽固醇在中年上昇後,在老於75歲後卻又下降。其餘伴隨老化之生化試驗改變,雖然有些項目具統計學上差異,然並不具臨床意義。老年組及非常老年組之乙型肝炎病毒表面抗原陽性率偏低,及乙型肝炎病毒表面抗原及抗體均呈陰性之比率上升,可能是肇因於老年人乙型肝炎病毒血清標誌隨著年齡增長而持續漸消失。 |
英文摘要 | Background: Human liver alters with aging. Lower serum albumin with elevation in serum cholesterol and alkaline phosphatase (ALP) has been reported in the elders, but there was no further report on the very old people (i.e., > 75 Y/O). We evaluated changes of liver biochemical tests and hepatitis B virus (HBV) serological markers in the very old-aged population. Methods: From October 1993 to June 1994, 2,549 subjects attended our hospital for physical check-up. Of them 1,742 were healthy subjects (M/F = 1,058/648) and were enrolled for analysis of the normal range of liver biochemical tests in different age groups. They were divided into four groups; young-aged group (age between 18 and 40, n=231), middle-aged group (age between 41 and 64, n=991), old-aged group (age between 65 and 75, n=424), and very old-aged group (age >= 76, n=96). The items of liver biochemical tests included albumin, total bilirubin, cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), ALP and gamma-glutamyl transpeptidase (GGT). The whole population, totally 2,549 subjects, were used for the analysis of the prevalence of HBV serological markers in different age groups. Results: Serum albumin was the only biochemical parameter that persisted to decline after the age of 75 (p < 0.05). Cholesterol began to elevate in the iddle-age but decreased after 75 Y/O. The old-aged and very old-aged subjects had higher levels of serum bilirubin, AST, ALP and GGT levels than the other two groups (p < 0.05), however, the changes of ALT levels among these groups were not so remarkable. The HBV carrier rates in the young-aged, middle-aged, old-aged and the very old-aged groups were 16.8%, 12.3%, 6.8% and 7.0%, respectively (p < 0.001). Furthermore, the very old-aged group had a significantly higher prevalence of negativity in both HBsAg and anti-HBs (p < 0.001). Conclusions: Serum albumin is the only biochemical parameter that persists to decline after the age of 75. In contrast, elevation of cholesterol tends to reverse after that age. All the aging-related changes in biochemical tests are clinically nonsignificant though some of them are significant in statistical analysis. In addition, a low HBV carrier rate and a high prevalence of negativity in both HBsAg and anti-HBs are noted in the very old-aged people, possibly due to the progressive loss of HBV markers in the elders. |
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