慢性肾脏病患者若干血清酶的变化及临床意义

目的探讨慢性肾脏病（CKD）3～5期患者血清酶的变化及其临床意义。方法273例CKD患者根据肾小球滤过率分为三组，检测其血清酶指标，包括天门冬氨酸氨基转移酶（aspartate aminotransferase，AST）、丙氨酸氨基转移酶（alanine aminotransferase，ALT）、肌酸激酶（creatinekinase，CK）、乳酸脱氢酶（lactate dehydrogenase，LDH）、碱性磷酸酶（alkaline phosphatase，ALP），各组间进行比较，并分别与70例健康体检者（健康对照组）进行比较。结果CKD5期患者的CK、LDH水平高于健康对照组及CKD3、4期；CKD3～5期患者血清ALP水平高于健康对照组，AST水平低于健康对照组；ALT在本研究中各组间差异无统计学意义。结论CKD患者部分血清酶水平不同于健康对照组，这种变化可能与慢性肾脏病患者肾性骨病、贫血、感染等有关，可对疾病临床诊断产生一定的影响。

Objective To explore the change and clinical significance of serum enzymes in patients with stage Ⅲ- Ⅴ chronic renal disease（CKD）. Methods 273 patients with CKD were enrolled. The patients were divided into three groups according to glomerular filtration rate. Serum aspartate aminotransferase （ AST）, alanine aminotransferase （ ALT）, creatine kinase （ CK ）, lactate dehydrogenase（ LDH ）, alkaline phosphatase （ALP） were detected. Results The levels of serum CK, LDH were significantly higher in the patients with stage V CKD than normal volunteers and stage Ⅲ, Ⅳ CKD. The levels of serum ALP in patients with stage Ⅲ- Ⅴ CKD were significantly higher than those obtained from normal volunteers. The levels of AST were lower than those obtained from normal volunteers. There were no significantly difference on the levels of ALT. Conclusions The change of serum enzymes in patients with CKD is significant. It was postulated that they may be the consequence of renal osteodystrophy, anaemia and infection. This change may affect the diagnosis of the diseases.