比较血清BHMT和传统肝功指标对急性中毒性肝损伤诊断价值

Comparison and analysis of serum BHMT and traditional indexes of liver function in the diagnosis of acute toxic liver injury

【目的】比较和分析血清甜菜碱高半胱氨酸甲基转移酶（betaine homocysteine S-methyltransferase,BHMT）和传统肝功指标用于诊断急性中毒性肝损伤的临床价值。【方法】采用ELISA法检测血清样本中的BHMT,检测样本为正常人体检血清和急性中毒患者血清。【结果】建立人血清中BHMT含量的95%医学参考值范围为0~28.01 ng/ml;检测的110份临床血清样本中的BHMT含量做受试者工作特征曲线（receiver operating characteristic curve,ROC）分析,得出BHMT用以诊断急性肝损伤的Cutoff值为65.92 ng/ml,灵敏度为0.94,特异度为0.94,准确度为0.94,约登指数为0.89,提示BHMT具有较高的诊断价值;3例急性肝损伤患者血清中的BHMT和传统的谷丙转氨酶（alanine aminotransferase,ALT）随时间的变化趋势图提示BHMT可能较ALT更灵敏,其达到高值的时间点更早,升高的幅度更大。【结论】在诊断急性中毒性肝损伤时,BHMT具有较高的诊断价值,同时可能具有更好的灵敏性。

【Objective】To compare and analyze the clinical value of serum betaine homocysteine S-methyltransferase（BHMT） and traditional indexes of liver function in the diagnosis of acute toxic liver injury.【Methods】Serum BHMT was detected via ELISA. Serum samples came from normal persons and patients with acute poisoning.【Results】The 95% medical reference value range of human serum BHMT content was from 0 to 28.01 ng/ml. In addition, 110 cases of clinical samples underwent ROC analysis. The obtained Cutoff value of BHMT as a diagnostic index of acute liver injure was 65.92 ng / ml, with a sensitivity of 0.94, specificity of 0.94, accuracy of0.94, and Youden index of 0.89. These results indicated that the index BHMT was of a high diagnostic value. The tendency chart that BHMT and ALT in the sera of 3 patients with acute liver injury changed with the time showed that BHMT might be more sensitive than ALT; its time point of high value was earlier; its rising amplitude was higher.【Conclusion】BHMT was of a high diagnostic value, and has a better performance in terms of sensitivity for the diagnosis of acute liver injury.