酒精性肝病的实验室诊断的临床研究

Alcoholic liver disease's laboratory diagnosis clinical research

目的研究实验室诊断在酒精性肝病的诊断中临床应用价值。方法通过测定健康者、酒精性肝病患者、非酒精性肝病(甲肝、乙肝、肝硬化、肝癌)患者发病期(ALT≥65 U/L)及治疗后(ALT≤65 U/L)血液中天冬氨酸转氨酶同工酶(m-AST)、纤维结合蛋白(Fn)、γ-谷氨酰转移酶(r-GT)的变化进行分析。结果m-AST在ALD组和NALD组中的阳性检出率分别为75%与46%(P<0.05),Fn在ALD组和NALD组中的阳性检出率57%与60%(P>0.05),-γGT在ALD组及NALD组中阳性检出率90%与88%(P>0.05);m-AST在ALD组19.3±10.3 U/L与对照组t检验P<0.05与NALD组t检验P<0.05;Fn在ALD组335.6±59.5 mg/L与对照组t检验P<0.05与NALD组t检验P>0.05;r-GT在ALD组67.5±54.4 U/L与对照组t检验P<0.05与NALD组t检验P>0.05;ALD组治疗前后m-AST、Fn下降较为明显,经t检验P<0.05说明治疗前后m-AST、Fn的结果有显著性差异。结论血清m-AST活性测定对有无活动性酒精性肝病有诊断和鉴别、及疗效有诊断价值;Fn的测定对早期判断酒精性肝病以及治疗疗效有一定价值,是判断病情严重程度、预后的良好指标;r-GT酶诊断酒精性损伤的敏感性甚高但-γGT增高的特异性不高。

Objective Research laboratory diagnosis of alcoholic liver disease in the diagnosis of clinical value.Methods De- temlination of health, alcoholic liver disease patients, non-alcoholic liver disease （ hepatitis A, hepatitis B, cirrhosis, liver cancer） inci- dence in patients with Stage（ALT ≥65 U/L） and after trealment （ALT ≤ 65 U/L） in the blood isozyme aspartate aminotmnsferase （m-AST）,fiber-binding protein （Fn）,r-glutamyl transferase （γ-GT） In the analysis. Results m-AST in AID group and NALD group in the positive rates were 75% and 46% （ P 〈 0.05） ,Fn in AID group and the group NAIl）positive rate of 57% and 60% （ P 〉 0.05 ）, ;γ-GT in ALD group and NALD group in the positive rate was 90% and 88% （P 〉 0.05） ;m-A ST in AID group 19.3±10.3 U/L with the control group t-test P 〈 0.05 and NALD group t-test P 〈 0.05, Fn in-ALD Group 335.6 ± 59.5 mg/L with the contrel group t-test P 〈 0.05 and NALD group t-test P 〉 0.05, F-GT in ALD group 67.5± 54.4 U/L with the control group t test P 〈0.05 and NALD group t-test P〉0.05;ALD before and after treatment m-AST, Fn fell more distinctly,The t-test P 〈0.05 note before and after treatment m-AST, Fn the results of a significant difference. Conclusion m-AST activity of whether the activities of alcoholic liver disease diagnosis and differential diagnosis have value; Fn early judgement on the determination of alcoholic liver disease and the treatment of a certain value,the severity of the judgement,a good indicator of prognosis; r-GT diagnosis of alcohol injury but the high sensitivity of the γ-GT increased specificity is not high.