生化指标在肝病诊断中的临床评价

The evaluation of biochemical parameters in diagnosis of liver disease

目的探讨生化指标在肝病中的变化。方法使用全自动生化分析仪对300例各种肝病（急性肝炎、慢性肝炎、肝硬化、酒精性肝炎、重型肝炎、肝癌）和30例健康人血清中N-乙酰-β—D氨基葡萄糖苷酶（NAG）、α-岩藻糖苷酶（AFU）、亮氨酸氨基肽酶（LAP）、天冬氨酸氨基转移酶同工酶（ASTm）、谷氨酸脱氢酶（GLDH）、腺苷脱氨酶（ADA）、胆碱酯酶（CHE）的含量进行比较。结果在急性肝炎时LAP、ASTm、GLDH、ADA和AFU均显著增高，阳性率分别为93．0％、81．0％、76．0％、82．0％、83．2％；肝硬化时ADA、AFU和NAG均显著升高，阳性率分别为88．5％、38．2％、94．2％；重型肝炎时ADA和NAG显著升高，阳性率分别为64．9％和95．7％；肝癌时LAP、NAG均显著升高，阳性率分别为75．0％和88．O％。结论对急性肝炎诊断意义较大的指标为LAP和ASTm；对肝硬化诊断意义较大的指标为ADA、ASTm和CHE；对重型肝炎诊断意义较大的指标为ASTm、CHE、AFU和GLDH；对原发性肝癌诊断意义较大的指标为AFU和LAP。

Objective To investigate the changes of biochemical parameters in liver disease. Methods Serum contents of NAG, AFU, LAP, ASTm, GLDH,ADA, and CHE were determined with autobiochemical analyzer and analyzed in 300 hepatitis patients and 30 healthy subjects. Results The mean values of LAP, ASTm, GLDH, ADA and AFU in acute hepatitis patients were significantly higher than control, positive rate were 93.0% ,8!. 0%, 76. 0% ,82. 0% and 83.2% respectively;The mean values of ADA,AFU and NAG in liver cirrhosis patients were higher than control significantly, positive rate of were 88. 5% ,38. 2% and 94. 2% respectively;The mean values of ADA and NAG in severe hepatitis patients were higher than control significantly, positive rate are 64. 9% and 95.7% respectively; The mean values of LAP and NAG in liver cancer patients were higher than control significantly, positive rate were75.0 % and 88.0% respectively. Conclusion The index of LAP and ASTm are valuable markers for diag- nosing of acute hepatitis ; The index of ADA, ASTm and CHE are valuable marker for diagnosing of liver cirrhosis; The index of ASTm, CHE, AFU and GLDH are valuable marker for diagnosing of severe hepatitis, and AFU and LAP are valuable markers for diagnosing of hepatocellular carcinoma.