献血者血清ALT活性的研究

The study of serum ALT activity among the voluntary blood donors

目的评估献血者血清丙氨酸转氨酶(ALT)活性参考范围及在献血员筛选中的意义。方法对血清标志物HBsAg、HIV蛳Ab1/2、anti蛳TP阴性的无偿献血者7332例进行HCV蛳Ab检测(酶联免疫吸附法)及血清ALT活性检测(连续监测法),并对数据进行统计学分析。结果7262例HCV蛳Ab阴性无偿献血者的血清ALT活性呈偏态分布,中位数为13U/L,第5、25、75、95百分位数分别为7、10、20、49U/L。无偿献血者的血清ALT活性在不同性别间有非常显著性差异(P<0.01),男性高于女性。男性、女性以及全部无偿献血者在不同年龄组之间血清ALT活性均有非常显著性差异(P<0.01),并且随年龄增长而升高,男性40岁后有下降趋势,但无显著性差异(P>0.05)。全部7332例无偿献血者中HCV蛳Ab阳性者70例,ALT>40U/L者527例,ALT>40U/L且HCV蛳Ab阳性者10例,仅占HCV蛳Ab阳性者的14.3%(10/70),占ALT>40U/L者的1.9%(10/527)。结论无偿献血人群中血清ALT活性呈偏态分布,第95百分位数血清ALT活性为49U/L,存在性别及年龄差异,血清ALT活性已逐渐失去作为筛选非甲非乙型肝炎无偿献血者替代指标的意义。

Objective To evaluate the reference range of serum alanine aminotransferase （ALT） level among voluntary blood donors and the significance of serum ALT test in blood donors screen. Methods 7332 voluntary blood donors were from the Central Blood Bank of Peking Union Medical College Hospital with serum negative for HBsAg, HIV-Ab1/2, anti-TP were negative. The serum markers of HCV-Ab and serum ALT activity were measured. The data were analyzed by statistics. Results The distribution of serum ALT activity was positive by skewed among 7262 voluntary, blood donor whose serum markers for HCV-Ab were negative. The median was 13U/L. The 54, 254, 754, 954 percentile were 7,10,20,49U/L. There was significant difference （P〈0.01） between male and female, and among vorious age. The serum ALT activity of male was declined in mece older than 40 years old, but it was statistically insignificant（P〉0.05）. 70 cases had positive whose serum HCV-Ab was positive and 527 cases had serum ALT activity over 40U/L. There were 10 cases whose serum ALT activity was over 40U/L and serum HCV-Ab was positive, this indicated that only 14.3%（ 10/70）of case whose serum HCV-Ab were positive and only 1.9%（10/527）of case whose serum ALT activity was over 40U/L. Conclusions The distribution of serum ALT activity is positively skewed among voluntary blood donors. The serum ALT activity of 954 percentile is 49U/L. There is significant difference in sex and age. The significance of detection of serum ALT activity as the surrogate marker for the screen of non-A, non-B hepatitis among the voluntary blood donors is declining.