Alterations of Serum Transaminase in the Patients of Hepatitis B after Exercise

B型肝炎患者運動後之肝功能變化之研究

柯成國(Chen-Guo Ker) ； 羅海韻(Hoi-Wan Lo) ； 阮仲洲(Chung-Chou Jua) ； 李來涼(Lai-Liang Lee) ； 王淑芬(Shu-Fen Wang) ； 劉寬惠(Koan-Huey Liou)

《南臺灣醫學雜誌》 1卷1期 (2006/06) Pp. 33-39

https://doi.org/10.6726/MJST.200606_1(1).0004

摘要

目的：肝炎在台灣是屬於高盛行率地區，所以在運動選手之中發生B型肝炎之機率也是很高，而且這些運動選手必需接受不同程度的運動訓練，這種劇烈運動是否對合併有B型肝炎之選手肝功能是否有傷害，在本省尚缺乏資料，因此本研究將門診之中有B型肝炎病患，接受一定程度之運動，觀察比較運動前後之肝功能變化。方法：在門診之較年輕肝炎病患分組實驗。A組（n=20）：無肝炎正常對照組；B-1組（n=11）為B型肝炎，但肝功能正常；B-2組（n=15）B型肝炎但肝功能異常。各組均接受在慢跑機上慢跑30分鐘之運動，運動強度以各人能忍受以下為限制標準，運動前抽血檢查，運動後亦抽血一次，再比較前後之變化。檢查項目包括AST、ALT、心跳及末梢紅血求氧氣濃度（SpO2）。將這些檢查資料輸入電腦，再以統計學分析，其P值小於0.05始應為意義之相差。結果：運動前後之SpO2值甚為相近，因此排除本實驗對象沒有因為心臟問題而有造成特異數據資料。運動前後肝功能指數變化方面，在B-2組之運動後上升指數為有意義之相差，也就是在B型肝炎之肝功能不正常其運動後之肝功能指數會有意義的上升。然而在B型肝炎組再分HBeAg陽性時，其運動前後肝功能指數上升亦為有意義的差異，表示HBeAg陽性之B型肝炎更有須要高運動是要有限制。結論：運動對一般人或有肝炎的人都是有正面的，可改善肝臟血流改善病人疲倦感及心理建設。在本實驗可知這種程度的運動對肝功能不正常者是要有限制的。但對於高運動量者宜個案，由專家評估才能避免對運動者之傷害。

關鍵字

B型肝炎 ； 肝功能 ； 運動

並列摘要

Purpose: Hepatitis was commonly found in Taiwan due to high prevalence rate. Without exception, the incidence rate of hepatitis in the national candidates for sport perfor-mance will be the same as general populat-ion and they have to accept more intensive training program. In order to prevent the harmful effect to the national candidates, we try to study the serum transaminase (AST & ALT) the in the patients of hepatitis B before and after exercise.Methods: Forty-six subjects were encountered for study. There were three groups were classified; Group A (n=20) healthy person of non hepatitis as a control; Group B-1 (n=11), healthy hepatitis B patients with normal level of AST & ALT; Group B-2 (n=15), hepatitis B patients with elevation of AST & ALT. All test subjects had to accept exercise of continuous running on the running machine for 30 minutes. Before the exercise and soon after the exercise for 30 minutes, those patients had to check heart rate, saturation rate of peripheral erythrocytes (SpO2), AST and ALT.Results: The alteration of serum transamin-ase between before and after exercise test of B-1 and B-2 groups were significant differ-ence. In addition, in the group hepatitis B, the alterations of transaminase were of sig-nificant difference in the patients of HBeAg positive group after exercise test.Conclusion: The elevations of values were clear in the patient hepatitis B especially in the status of abnormal level of transaminase before exercise. It was advisable not to en-courage these patients to have an intensive physical training of high loading exercise if there were in the status of hepatitis B with abnormal liver functional test, especially if they had positive HBeAg.

並列關鍵字

hepatitis B ； transaminase ； physical exercise