Blood serum concentration of aminotransferases in the gunshot victims
DOI:
https://doi.org/10.22141/2224-0586.18.1.2022.1460Keywords:
gunshot wounds, post-traumatic period, transaminasemia, clinical significanceAbstract
Background. In the structure of modern injuries, gunshot and mine injuries are becoming increasingly important. Gunshot wounds are characterized by severe course with frequent development of local and general complications, among which an important place is occupied by hepatic dysfunction, which is most often manifested in an increase in markers of cytolysis in blood plasma — transaminasemia. The study was aimed to determine the diagnostic value of transaminasemia in victims with gunshot wounds. Material and methods. A retrospective analysis of 373 medical histories of servicemen wounded during the armed conflict in eastern Ukraine in 2014–2020, who were hospitalized at the National Military Medical Clinical Center and the military medical clinical centers of the North, South, Eastern regions of the Ministry of Defense of Ukraine. The concentration of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) on days 1–2, 3–13, 14 and more after injury was analyzed. Results. It was found that almost two-thirds of gunshot victims on days 1–2 after the injury experienced an increase in aminotransferases concentration. After two weeks or more, a significant increase of transaminases (more than 80 IU/l) persists in more than 40 % of the injured. In all terms of the study, the concentration of AST increased more significantly against the concentration of ALT. In the first and second follow-up periods, in most cases, the De Ritis ratio was over 1.3, and two or more weeks after the injury, the number of injured with a De Ritis ratio less than 0.8 increased significantly. Conclusions. 1. Transaminasemia in gunshot victims in the post-traumatic period is observed in almost 75 % of cases. 2. The reasons for transaminasemia in gunshot victims can be not only the liver damage but also other tissues that were damaged during the primary injury or as a result of secondary systemic disorders. 3. For the interpretation of transaminasemia, it is necessary to take into account not only the fact of increase but also the location and features of the wound, the degree of increase in aminotransferases, their ratio and dynamics in the posttraumatic period, which requires further study.
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