血清谷氨酰转肽酶对慢性重型肝炎预后判断的价值

Serum γ-glutamyl transferase values predict prognosis of chronic severe hepatitis

目的探讨血清γ-谷氨酰转肽酶（γ-glutamyl transferase，GGT）对慢性重型乙型肝炎预后判断的价值。方法测定56例慢性重型乙型肝炎病人血清SB、PT、Cr、ALP、GGT水平，同时计算出56例病人的终末期肝病模型（model for end-stage liver disease，MELD）分值，分析存活组和死亡组GGT、MELD以及二者之间的关系。结果存活组GGT值为（121．7±68．1）U／L，死亡组GGT值为（34．7±34．9）U／L，（t=3．25，P〈0．01）；存活组MELD值为（19．2±12．1），死亡组MELD分值为（28．8±11．9），（t=2．5，P〈0．05）。56例GGT值为（77．2±68.3）U／L，MELD分值为（23．2±11．5），二者呈负相关（r=-0．34，P〈0．05）。慢性重型乙型肝炎肝性脑病合并肝肾综合征以及肝性脑病合并上消化道出血两组比较，GGT值无显著差异（P〉0．05），MELD分值有非常显著差异（P〈0．001）。结论GGT是判断重型肝炎预后的一个有意义的指标。

Objective To explore predictive factors for the prognosis of chronic severe hepatitis. Methods Serum total bilirubin （TB）, prothrombin time （PT）, creatinine （Cr）, alanine aminotransferase （ALT）, and γ-glutamyl transferase （GGT） were detected and an MELD score was calculated in 56 patients with chronic severe hepatitis. The GGT value, the MELD score and their correlations in survival and death groups were analyzed. Results The GGT value in the survival （121.7±68.1） group was significantly higher than that in the death group （34.7±34.9） （t=-3.25, P〈0.01）. In contrast, the MELD score in the survival group （19.2±12.1） was significantly lower than that in the death group （28.8±11.9） （t=-2.5, P〈0.05）. There was an evidently negative correlation between the GGT value and the MELD score （r=-0.679, P〈0.01）. No GGT score different was noticed between hepatorenal syndrome with hepatic encephalopathy group and upper gastrointestinal bleeding with hepatic encephalopathy group; however, a significant difference in the MELD score was noticed between them. Conclusion Serum γ-glutamyl transferase is a useful predictor for the prognosis of chronic severe hepatitis.