不同类型肝胆疾病肝损伤酶活性联合检测的诊断价值

Clinical value of combined detection of liver injury and enzyme activity in diagnosis of different types of hepatobiliary diseases

目的探讨肝损伤酶活性指标在不同类型肝胆疾病中的诊断价值。方法选取100例慢性病毒性肝炎(甲组)和50例肝硬化(乙组)及50例肝癌(丙组)患者作为本次研究对象,另选取同期于医院健康体检的50例健康人群作为研究对照组。分别检测各研究对象血清总胆汁酸(TBA)和5’-核苷酸(5’-NT)、γ-谷氨酰基转移酶(GGT)及丙氨酸氨基转移酶(ALT)水平。结果甲乙丙三组患者血清5’-NT、TBA、GGT及ALT水平明显高于对照组,P<0.05;甲乙丙三组血清5’-NT、TBA、GGT及ALT水平比较,P<0.05。结论ALT水平并不能较好的反映出肝脏疾病患者病情严重程度,而低水平ALT可作为慢性病毒性肝炎伴肝硬化或肝癌的评价指标。对于肝硬化或慢性病毒性肝炎者来说,如患者GGT水平出现明显升高则可警惕肝癌发生。检测血清5’-NT和GGT水平可作为临床监测慢性病毒性肝炎伴肝硬化或肝癌的重要指标,且可作为临床判断肝脏疾病患者预后和病情转归的重要指标。

Objective To explore the diagnostic value of liver injury enzyme activity index in different types of hepatobiliary diseases.Methods 100 patients with chronic viral hepatitis(group A)and 50 patients with liver cirrhosis(group B)and 50 patients with liver cancer(group C)were selected as the study subjects.50 healthy people in the same period in the hospital for physical examination were selected as the study control group..Serum total bile acid(TBA)and 5’-nucleotide(5’-NT),γ-glutamyltransferase(GGT)and alanine aminotransferase(ALT)levels were measured for each subject.Results The levels of serum 5’-NT,TBA,GGT and ALT in the three groups were significantly higher than those in the control group(P<0.05).The levels of serum 5’-NT,TBA,GGT and ALT in the three groups were compared,P<0.05.Conclusion The level of ALT does not reflect the severity of liver disease,and low level ALT can be used as an indicator of chronic viral hepatitis with cirrhosis or liver cancer.For patients with cirrhosis or chronic viral hepatitis,if the patient’s GGT level is significantly increased,it can be alert to liver cancer.Detection of serum 5’-NT and GGT levels can be used as an important indicator for clinical monitoring of chronic viral hepatitis with cirrhosis or liver cancer,and can be used as an important indicator for clinical judgment of prognosis and outcome of patients with liver disease.