5'-NT和γ-GT在婴儿肝炎综合征与胆道闭锁鉴别诊断中的价值

Significance of serum 5'-Nucleotidase and γ-glutamyltranspeptidase in differential diagnosis for infantile hepatitis syndrome and biliary atresia

目的观察血清5'-核苷酸酶(5'-NT)、γ-谷氨酰转肽酶(γ-GT)活性的变化在淤胆型婴儿肝炎综合征与胆道闭锁鉴别诊断中的价值。方法采用法国梅里埃公司5'-NT诊断试剂盒,同时采用全自动生化分析仪测定60例阻塞性黄疸(28例胆道闭锁和32例婴儿肝炎)患儿及20例正常对照组婴儿血清5'-NT,γ-GT,血清总胆红素(TBILT),直接胆红素(DBILT)水平。结果在28例胆道闭锁和32例婴儿肝炎病例中,5'-NT和γ-GT均数较20例正常对照组升高(P<0.05),5'-NT和γ-GT均数在胆道闭锁组明显高于淤胆型婴儿肝炎综合征组(P<0.05),在胆道闭锁病例中,5'-NT与γ-GT、TBILT和DBILT呈正相关(P<0.05)。结论血清5'-NT及γ-GT的测定有助于淤胆型婴儿肝炎综合征和胆道闭锁的鉴别诊断。

Objective The significance of changes in serum activities of 5＇- nucleotidase （5 ＇- NT） and γ - glutamyhranspeptidase （ γ - GT） in differential diagnosis of cholestatie hepatitis syndrome and biliary atresia in infantile patients had been studied. Methods The diagnostic kit for 5＇- NT produced by Merieux Company in France was applied in this study. The determination of serum levels of 5＂- NT, γ - GT, total bilirubin （TBILT） and direct bilirubin （DBILT） was performed by automatic biochemical analyzer. Results This study was carried out in 28 cases of biliary atresia, 32 cases of infantile hepatitis syndrome and 20 normal controls, the average figures of 5＇- NT and γ - GT in 20 cases were higher than those of normal controls （ P 〈 0.05 ）, and the mean figures of 5＇- NT and γ - GT in patients with biliary atresia were significantly higher than those of infantile patients with cholestatic hepatitis syndrome （ P 〈0.05 ） . There was positive correlation among 5＇-NT and γ -GT, TBILT and DBILT in cases of biliary atresia （ P 〈 0.05 ）. Conclusion The determination of serum activities of 5＇- NT and γ - GT is helpful in differential diagnosis of cholestasis caused by cholestatic hepatitis syndrome and hiliary atresia in infantile patients.