基于某医院体检数据的医务人员血清转氨酶水平的影响因素研究

王井; 曹大龙; 吴学森; 芈静

doi:10.16766/j.cnki.issn.1674-4152.002475

基于某医院体检数据的医务人员血清转氨酶水平的影响因素研究

doi: 10.16766/j.cnki.issn.1674-4152.002475

王井^{1, 2},
曹大龙³,
吴学森¹,
芈静^1, ,

1.
蚌埠医学院公共卫生学院，安徽蚌埠 233000
2.
蚌埠市第一人民医院护理部，安徽蚌埠 233000
3.
蚌埠市第一人民医院呼吸内科，安徽蚌埠 233000

基金项目:

安徽高校自然科学研究重点项目 KJ2021A0710

；蚌埠医学院2020年度研究生创新计划项目 Byycx20055

详细信息

通讯作者:
芈静，E-mail: xiaomi05011@sina.com

中图分类号: R446.11 R575
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- 文章访问数: 356
- HTML全文浏览量: 178
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2021-12-17
- 网络出版日期: 2022-09-05

Analysis on influencing factors of serum transaminase of medical staff based on physical examination in a hospital

WANG Jing^{1, 2},
CAO Da-long³,
WU Xue-sen¹,
MI Jing^{1
, ,}

1.
School of Public Health, Bengbu Medical College, Bengbu, Anhui 233000, China

摘要

摘要: 目的通过对8年间某三级综合医院医务人员体检档案进行分析，旨在了解丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)异常检出情况并对其影响因素进行研究，为制定前瞻性、针对性、个性化的健康管理方案提供依据。方法通过描述性研究对2012—2019年某三级综合医院的6 074名职工体检档案进行整理分析，对ALT、AST水平的影响因素进行单因素分析，并将单因素分析中有统计学意义的研究变量引入logistic回归分析，研究ALT、AST的影响因素。结果研究对象中ALT异常检出率为10.96%，男性检出率显著高于女性(68.47% vs. 31.53%)，AST异常检出率为2.49%，男性检出率显著高于女性(60.26% vs. 39.74%)。Logistic回归分析结果显示女性是ALT的保护因素，OR值(95% CI)为0.273(0.221~0.331)，DBP升高、尿酸(UA)升高、RBC升高是ALT的危险因素，OR值(95% CI)分别为1.455(1.126~1.882)、1.516(1.177~1.952)、1.884(1.325~2.680)，年龄大、UA升高是AST的危险因素，OR值(95% CI)分别为1.626(1.116~2.369)、2.013(1.371~2.957)。结论医务人员肝功能状况不容乐观，医务人员应具有爱肝护肝意识，定期体检并重视体检结果，改变生活态度、生活方式和生活习惯，保持身心健康。
- 丙氨酸氨基转移酶 /
- 天门冬氨酸氨基转移酶 /
- 医务人员 /
- 体检
Abstract: Objective To understand the abnormal detection and its influencing factors of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) among medical staff in a tertiary general hospital based on physical examination data during 8 years for providing evidence in making prospective, targeted and personalized health management programs. Methods Medical Physical examination data of 6 074 staffs in a tertiary general hospital from 2012 to 2019 were collected and analyzed. Univariate analysis was conducted to analyze the influencing factors of ALT and AST, and further variables with statistical significance were included in logistic regression analysis. Results The abnormal detection rate of ALT was 10.96%, which was significantly higher in male than that in female (68.47% vs. 31.53%). The abnormal detection rate of AST was 2.49%, which was significantly higher in male than that in female (60.26% vs. 39.74%). Logistic regression analysis showed that female was the protective factor for ALT, with the OR(95% CI) of 0.273 (0.221-0.331), while higher DBP, higher UA and higher RBC were the risk factors for ALT, with the OR(95% CI) of 1.455 (1.126-1.882), 1.516 (1.177-1.952) and 1.884 (1.325-2.680). Older age and higher UA were the risk factors for abnormal AST, with the OR(95% CI) of 1.626 (1.116-2.369) and 2.013 (1.371-2.957). Conclusion The status of liver function of medical staff is not optimistic. It is necessary to arouse the consciousness of loving liver and protecting liver. Medical staff should take regular physical examination, pay attention to the results of physical examination, change life attitude, life style and life habits, and maintain physical and mental health.
- Alanine aminotransferase /
- Aspartate transaminase /
- Medical staff /
- Physical examination

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表 1 医务人员ALT单因素分析[例(%)]

Table 1. Univariate analysis of ALT in medical staff [cases (%)]

项目	异常组 (n=666)	正常组 (n=5 408)	统计量	P值
年龄(岁)			0.058^a	0.809
< 40	402(11.04)	3 238(88.96)
≥40	264(10.85)	2 170(89.15)
性别			352.201^a	< 0.001
男性	456(21.08)	1 707(78.92)
女性	210(5.37)	3 701(94.63)
HDL			-8.810^b	< 0.001
低	49(24.75)	149(75.25)
正常	582(11.05)	4 685(88.95)
高	35(5.75)	574(94.25)
LDL			-6.677^b	< 0.001
低	47(7.45)	584(92.55)
正常	270(8.33)	2 973(91.67)
高	349(15.86)	1 851(84.14)
UA			-14.020^b	< 0.001
低	1(1.79)	55(98.21)
正常	490(9.11)	4 890(90.89)
高	175(27.43)	463(72.57)
FBG			-8.506^b	< 0.001
低	1(2.70)	36(97.30)
正常	566(10.09)	5 046(89.91)
高	99(23.29)	326(76.71)
STB			-5.135^b	< 0.001
低	0	9(100.00)
正常	502(10.04)	4 496(89.96)
高	164(15.37)	903(84.63)
RBC			-7.581^b	< 0.001
低	4(7.55)	49(92.45)
正常	592(10.30)	5 157(89.70)
高	70(25.74)	202(74.26)
Hb			-10.642^b	< 0.001
低	6(2.61)	224(97.39)
正常	443(9.35)	4 295(90.65)
高	217(19.62)	889(80.38)
AST			975.922^a	< 0.001
异常	135(89.40)	16(10.60)
正常	531(8.97)	5 392(91.03)
SBP			61.894^a	< 0.001
异常	100(22.08)	353(77.92)
正常	566(10.07)	5 055(89.93)
DBP			121.184^a	< 0.001
异常	176(22.42)	609(77.58)
正常	490(9.26)	4 799(90.74)
注：^a为χ²值, ^b为Z值。

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表 2 医务人员AST单因素分析[例(%)]

Table 2. Univariate analysis of AST in medical staff [cases (%)]

项目	异常组 (n=151)	正常组 (n=5 923)	统计量	P值
年龄(岁)			6.786^a	0.009
< 40	75(2.06)	3 565(97.94)
≥40	76(3.12)	2 358(96.88)
性别			41.048^a	< 0.001
男性	91(4.21)	2 072(95.79)
女性	60(1.53)	3 851(98.47)
LDL			-4.425^b	< 0.001
低	12(1.90)	619(98.10)
正常	56(1.73)	3 187(98.27)
高	83(3.77)	2 117(96.23)
UA			-10.362^b	< 0.001
低	0	56(100.00)
正常	96(1.78)	5 284(98.22)
高	55(8.62)	583(91.38)
FBG			-6.269^b	< 0.001
低	0	37(100.00)
正常	121(2.16)	5 491(97.84)
高	30(7.06)	395(92.94)
TG			-8.300^b	< 0.001
低	5(0.69)	718(99.31)
正常	77(1.82)	4 160(98.18)
高	69(6.19)	1 045(93.81)
CB			31.868^a	< 0.001
异常	12(10.71)	100(89.29)
正常	139(2.33)	5 823(97.67)
TP			-4.760^b	< 0.001
低	0	3(100.00)
正常	121(2.19)	5 406(97.81)
高	30(5.51)	514(94.49)
RBC			-3.127^b	0.002
低	3(5.66)	50(94.34)
正常	131(2.28)	5 618(97.72)
高	17(6.25)	255(93.75)
Hb			-5.596^b	< 0.001
低	0	230(100.00)
正常	99(2.09)	4 639(97.91)
高	52(4.70)	1 054(95.30)
ALT			975.922^a	< 0.001
异常	135(20.27)	531(79.73)
正常	16(0.30)	5 392(99.70)
SBP			27.569^a	< 0.001
异常	28(6.18)	425(93.82)
正常	123(2.19)	5 498(97.81)
DBP			48.966^a	< 0.001
异常	48(6.11)	737(93.89)
正常	103(1.95)	5 186(98.05)
注：^a为χ²值, ^b为Z值。

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表 3 医务人员ALT多因素logistic回归分析

Table 3. Multivariate logistic regression analysis of ALT in medical staff

项目	B	SE	Wald χ²	P值	OR(95% CI)
性别女性	-1.298	0.107	147.423	< 0.001	0.273(0.221~0.337)
DBP高	0.375	0.131	8.187	0.004	1.455(1.126~1.882)
UA高	0.416	0.129	10.378	0.001	1.516(1.177~1.952)
RBC高	0.633	0.179	12.420	< 0.001	1.884(1.325~2.680)
注：性别以男性为参照；DBP、UA、RBC以正常为参照。

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表 4 参加体检医务人员AST多因素logistic回归分析

Table 4. Multivariate logistic regression analysis of AST among medical staff participating in physical examination

项目	B	SE	Wald χ²	P值	OR(95% CI)
年龄≥40岁	0.486	0.192	6.406	0.011	1.626(1.116~2.369)
UA高	0.700	0.196	12.727	< 0.001	2.013(1.371~2.957)
注：年龄以 < 40岁为参照，UA以正常为参照。

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