| The Study of Serum Aminotransferase and AST/ALT Ratio in Pediatric Patients with Acute Hepatitis |
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Soo Mi Jung, Chang Rang Kang, Man Taeg Oh, Jong Duck Kim |
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Department of Pediatrics, College of Medicine, Wonkwang University, Iksan, Korea |
| 어린이의 급성 간염에서 Transaminase와 AST/ALT비의 의의에 대한 고찰 |
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정수미, 강창랑, 오만택, 김종덕 |
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원광의대 소아과학교실 |
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| Abstract |
Purpose
: Serum level of the aminotransferase is the most common test in use to assess
hepatocellular injury and are sensitive test of hepatocyte necrosis, but both AST and ALT level
in serum rise in a variety of hepatic disorders. Some clinical study reports that AST/ALT ratio
was possible to predict prognostic outcome of infants with liver disease. We have tried to assess
whether AST/ALT ratio is valuable or not for predict prognosis of hepatitis and differentiate
cause of it.
Methods
: Serum AST, ALT, and AST/ALT ratio were evaluated in the infants with acute
hepatitis. They were grouped into 12 patients with Hepatitis B surface antigen positive
only(group I), 23 patients with Hepatitis B surface antibody positive only(group II), and 12
patients with not-known cause of hepatitis(group III). The 24 patients were able to follow-up of
AST and ALT for 2 months. They are grouped into 12 patients with normalized AST and ALT
within 2 months(group A) and 12 patients not normalized within 2 months(group B).
Results
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1) There were no statistical difference of mean serum level of AST and ALT that were tested
on admission day, one week and 2 week of admission respectively among the group I, II, and
III.
2) The value of AST/ALT ratio were increased from 0.6 on admission day to 0.9 after 2
week of admission in group I(p<0.05), decreased from 1.1 to 0.8 in group II. It were not
changed in group III.
3) The mean values of AST/ALT ratio were not statistically different in group A and B.
4) The mean values of serum alkaline phosphatase, total bilirubin, and prothrombin time were
not statistically different among these groups, if we exclude two cases of cholestatic jaudice, one
case of acute fulminant hepatitis, and one case of hepatitis C from these groups.
Conclusion
: On the basis of this study, we concluded that progression of hepatitis and
damage of hepatic cell was different according to the cause of hepatitis. AST/ALT ratio of the
acute phase hepatitis were not able to reflect the time duration of normalization of AST and
ALT and it was not related to etiology of hepatitis. For predict prognosis of infant with acute
hepatitis, long term follow up is needed in many more cases of infants with acute hepatitis. |
| Key Words:
Acute hepatitis, AST/ALT ratio |
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