Serum γ-glutamyltransferase,alanine aminotransferase,and aspartate aminotransferase activity in Iranian healthy blood donor men

AIM: To determine serum γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) activity, and to assess their correlation with demographic and clinical findings in healthy blood donors. METHODS: This cross-sectional study was performed in 934 male blood donors, aged 18 to 68 years, who consecutively attended Tehran blood transfusion service in 2006. All participants were seronegative for HBV or HCV infections, non alcohol users, and all underwent a standard interview and anthropometric tests. Clinical and biochemical parameters including AST, ALT, and GGT activities were determined. Patients taking drugs known to cause hepatic fat deposition were excluded. For AST, ALT, and GGT variables, we used 33.33 and 66.66 percentiles, so that each of them was divided into three tertiles. RESULTS: Mean AST, ALT, and GGT activities were 25.26 ± 12.58 U/L (normal range 5-35 U/L), 33.13 ± 22.98 (normal range 5-35 U/L), and 25.11 ± 18.32 (normal range 6-37 U/L), respectively. By univariate analyses, there were significant associations between increasing AST, ALT, or GGT tertiles and age, body weight, body mass index, and waist and hip circumferences (P < 0.05). By multiple linear regression analyses, ALT was found to be positively correlated with dyslipidemia (B = 6.988, P = 0.038), whereas ALT and AST were negatively correlated with age. AST, ALT, and GGT levels had positive correlation with family history of liver disease (B = 15.763, P < 0.001), (B = 32.345, P < 0.001), (B =24.415, P < 0.001), respectively.CONCLUSION: Although we did not determine the cutoffs of the upper normal limits for AST, ALT, and GGT levels, we would suggest screening asymptomatic patients with dyslipidemia and also subjects with a family history of liver disease.

Relationship between alanine aminotransferase levels and metabolic syndrome in nonalcoholic fatty liver disease

Objective： To investigate the relationship between alanine aminotransferase （ALT） levels and metabolic syndrome （MS） in nonalcoholic fatty liver disease （NAFLD）. Methods： A total of 26527 subjects who received medical health checkup in our hospital from January 2005 to July 2007 were enrolled in the study. The diagnosis of fatty liver was based on ultrasound imaging. MS was defined according to the criteria of the Adult Treatment Panel III. ALT, triglyceride （TG）, high density lipoprotein cholesterol （HDL-c）, fasting plasma glucose （FPG）, height, weight, waist circumference （WC）, systolic blood pressure （SBP） and diastolic blood pressure （DBP） were measured in each subject to analyze the relationship between MS and ALT activity Results： （1） The prevalence of NAFLD in men （30.94%） was significantly higher than that in women （15.65%）; （2） The incidence of MS in NAFLD （33.83%） was significantly greater than that in non-NAFLD （10.62%）; （3） Of the 6470 subjects with NAFLD, in the age-adjusted partial correlation analysis, there were statistically significant correlations between the ALT levels and most metabolic risk factors in each sex （P〈0.01）, except that ALT levels multiple stepwise regression analysis, SBP lost its significance, and had no correlation with HDL-c in women. Moreover, in the WC, body mass index （BMI）, age, DBP, TG and FPG were independently associated with ALT levels in both sexes （P〈0.05）. HDL-c remained significant and was independently related to ALT levels in men; （4） ALT levels were significantly higher in subjects with MS compared to those without MS （P〈0.001）. Mean ALT levels increased with the number of MS components in each sex （P〈0.05 for trend）. Conclusion： We found a strong relationship between ALT levels and MS in NAFLD and revealed that the cluster of MS components might be the predictor for ALT elevations.

Elevated alanine aminotransferase activity is not associated with dyslipidemias,but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

Objective:To explore demographic and metabolic factors associated with increased alanine aminotransferase(ALT)activity in non-diabetic non-alcoholic fatty liver disease(NAFLD)patients.Methods:Overall 372 patients who consecutively attended to Gastroenterology Clinic of Baqiyatallah University of Medical Sciences,Tehran,Iran awere diagnosed as NAFLD entered into analysis.Exclusion criteria were having diabetes mellitus and fasting blood glucose over126 mg/dL,active hepatitis B virus infection,having hepatitis C virus positive serology,and to be under corticosteroid therapy.ALT levels were considered pathologically high when it was over30 IU/L for men and over 19 IU/L for women.Results:Bivariate analyses using t test and chisquare test showed that patients with pathologically augmented ALT levels had significantly higher NAFLD grades in their ultrasonographic evaluations(P=0.003).Moreover,these patients represented significantly higher homeostatic model assessment levels(P=0.003),levels of serum insulin(P=0.002),fasting blood glucose(P<0.001),and uric acid(P=0.02).The prevalence of insulin resistance was also higher in patients with increased serum ALT concentrations.Multifactorial logistic regression models showed that ultrasonographic grading of NAFLD(P=0.027)and insulin resistance(P=0.013)were the only variables significantly associated with abnormal ALT levels.Conclusions:This study shows that the associations of increased ALT serum levels in NAFLD patients are different from what are supposed before.By excluding diabetic patients from our population,we find that increased ALT levels are not associated with dyslipidemias but are independently associated with insulin resistance and NAFLD grading on ultrasonographic evaluations.Further studies are needed to confirm our results.

Risk Factors, Clinical Features, Baseline Alanine Aminotransferase and CD4+ Count of Children with HIV Co-Infection with Hepatitis B and C at a Tertiary Hospital in Southwest Nigeria

Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4+ count, CD4+ percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: Of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4+ count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4+ count and ALT.

脑出血患者循环血中HBP、ALT、AST、WBC、NEU、PLT表达与感染及预后的相关性

目的:讨论脑出血患者循环血中肝素结合蛋白(heparin-binding protein,HBP)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、白细胞(white blood cell,WBC)、中性粒细胞比率(neutrophil,NEU)、血小板(platelet,PLT)表达水平,分析其与患者感染及预后的关系。方法:选取脑出血患者164例,入院和出院时分别检测循环血中HBP、ALT、AST、WBC、NEU和PLT水平,分组分析以上指标与感染和预后的相关性。结果:感染组HBP、WBC、NEU、PLT最高值水平均高于非感染组。感染组患者预后比较ALT和WBC最高值、非感染组患者预后比较NEU最高值,差异有统计学意义(P<0.05)。AST最高值是否异常在不同预后情况中比例相反。ROC曲线分析显示,HBP、ALT、AST、WBC最高值联合检测对脑出血患者预后不良的曲线下面积为0.781,敏感度和特异度分别为85.7%和62.7%。结论:脑出血患者循环血中HBP、WBC、NEU及PLT在检测中最高值异常高表达提示感染风险,当HBP、ALT、AST、WBC水平联合检测对脑出血患者预后不良具有较好的预测效能。

无偿献血者ALT检测不合格的影响因素分析

目的 探讨183例无偿献血者丙氨酸氨基转移酶(ALT)不合格影响因素,制订针对性护理干预策略,降低血液报废率。方法 选取2021年1月—2021年12月我市中心血站无偿献血者58677例作为研究对象,并收集献血者信息和采血信息。采用单因素和多因素Logistic回归分析筛选ALT的危险因素。结果 58677例无偿献血者中,出现ALT检测不合格者有183例0.31%。单因素比较显示献血者性别、年龄、文化程度、生活习惯、采集后是否应用全程血液冷链管理、阿森斯失眠量表(AIS)评分相比,差异有统计学意义(均P <0.05)。多因素Logistic回归分析显示男(OR=2.526)、46~55岁(OR=0.554)、生活习惯差(OR=4.585)采集后未应用血液冷链管理(OR=6.189)、AIS评分≥6分(OR=3.235)是无偿献血者ALT检测不合格的影响因素(均P <0.05)。结论 无偿献血者ALT检测不合格与献血者性别、年龄、生活习惯、AIS评分及是否应用全程血液冷链管理等多种因素相关,建议医护人员应严格规范采前初筛工作,并监管血液运输过程,以减少血液报废。

妊娠期糖尿病孕妇血WBC、FBG、Cr、ALT变化及早期筛查和风险评估价值

目的:探讨妊娠期糖尿病(GDM)患者白细胞计数(WBC)、空腹血糖(FBG)、血肌酐(Cr)与丙氨酸氨基转移酶(ALT)水平及早期筛查和风险评估价值。方法:回顾性分析2020年5月—2021年12月在本院产前检查的孕妇542例临床资料,分为GDM组(n=60)与对照组(n=482),对比两组WBC、FBG、Cr、ALT差异,采用Spearman相关系数分析以上指标与GDM发病关系;绘制受试者工作特征(ROC)曲线分析WBC、FBG、Cr、ALT早期筛查GDM效能;多因素回归分析GDM发病相关风险因子。结果:GDM组Cr、WBC、FBG、ALT表达均高于对照组,且均与GDM发病正相关(均P<0.05);ROC分析,WBC、FBG、Cr、ALT联合检测的曲线下面积最高(0.851),敏感度90.1%、特异度为87.6%;WBC≥6.41×10~9/L、FBG≥5.16mmol/L、ALT≥14.98U/L、体质指数≥22.32kg/m~2、Cr≥50.62μmol/L、吸烟是GDM发生的风险因子,而孕妇本科及以上学历为保护因素。结论:GDM妇女血WBC、FBG、ALT、Cr异常高表达,联合检测对早期筛查GDM有一定效能,控制BMI、降低吸烟频率并提高孕产妇知识储备对降低GDM发生有一定作用。

血清N-聚糖生物标志物诊断ALT水平正常慢性乙型肝炎患者显著肝纤维化和肝硬化的临床意义

本研究目的是探讨血清N-聚糖模型在285例丙氨酸转移酶(alanine aminotransferase,ALT)水平正常(<40 U·L^(-1))的慢性乙型肝炎(慢性乙肝)患者中诊断显著肝纤维化和肝硬化的临床意义。入组患者均进行肝组织活检,并使用Ishak评分系统评估患者肝组织纤维化程度。应用基于DNA测序仪的荧光糖电泳技术检测患者血清N-聚糖图谱,每例患者的血清样本中共鉴定出9个N-聚糖峰。利用机器学习算法,即随机森林(random forest,RF)构建更理想的血清N-聚糖模型,以诊断显著肝纤维化(≥F3)和肝硬化(≥F5),并比较血清N-聚糖模型和其他纤维化标志物的诊断效能。肝组织活检结果显示,有显著肝纤维化和肝硬化患者分别占63.86%(182/285)和16.49%(47/285),有显著炎症患者为4.91%(14/285)。血清N-聚糖RF-A模型具有很好的诊断显著肝纤维化(≥F3)的效能,其受试者工作特征曲线下面积(area under receiver operating characteristic curve,AUROC)为0.94,与肝活检的符合率为90.45%。在诊断肝硬化(≥F5)时,血清N-聚糖RF-B模型的AUROC为0.97,与肝组织活检的符合率为88.94%。血清N-聚糖模型(RF-A和RF-B)的诊断效能优于肝硬度值测量(liver stiffness measurement,LSM)、基于4因子的纤维化指数(fibrosis index based on the four factors,FIB-4)和天冬氨酸转氨酶与血小板比率指数(aspartate aminotransferase-to-platelet ratio index,APRI)。在ALT水平正常的慢性乙肝患者中,血清N-聚糖模型可作为诊断显著肝纤维化或肝硬化的潜在生物标志物。

清热渗湿降浊法联合水飞蓟宾葡甲胺片治疗湿热蕴结型非酒精性脂肪性肝炎临床疗效观察

【目的】探讨清热渗湿降浊法联合水飞蓟宾葡甲胺片治疗丙氨酸氨基转移酶(ALT)异常的湿热蕴结型非酒精性脂肪性肝炎(NASH)患者的临床疗效。【方法】采用回顾性研究方法,根据用药情况将80例ALT异常的湿热蕴结型NASH患者分为对照组和观察组,每组各40例。对照组给予水飞蓟宾葡甲胺片治疗,观察组在对照组的基础上联合清热渗湿降浊法治疗,疗程为12周。观察2组患者治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)]、血脂指标[总胆固醇(CHOL)、甘油三酯(TRIG)]以及肝脂肪度的变化情况,并评价2组患者的临床疗效及安全性。【结果】(1)经治疗12周后,观察组的总有效率为95.00%(38/40),对照组为77.50%(31/40);组间比较,观察组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的肝功能指标ALT、AST、GGT水平均较治疗前明显下降(P<0.05),且观察组对肝功能指标ALT、AST、GGT水平的下降作用均明显优于对照组(P<0.05)。(3)治疗后,2组患者的血脂指标CHOL、TRIG水平均较治疗前明显下降(P<0.05),且观察组对血脂指标CHOL、TRIG水平的下降作用均明显优于对照组(P<0.05)。(4)治疗后,2组患者的肝脂肪度均较治疗前明显下降(P<0.05),且观察组对肝脂肪度的下降作用明显优于对照组(P<0.05)。(5)治疗过程中,2组患者均未发生明显不良反应,具有较高的安全性。【结论】清热渗湿降浊法联合水飞蓟宾葡甲胺片治疗ALT异常的湿热蕴结型NASH患者疗效确切,联合清热渗湿降浊法治疗能显著提高临床疗效。

不同强度游泳应激对小鼠血清ALT、AST和ALP活性的影响

为了探讨不同强度游泳应激对小鼠血清谷丙转氨酶(ALT)、谷草转氨酶(AST)和碱性磷酸酶(ALP)活性的影响,试验选取40只昆明小鼠进行游泳试验,于游泳前和游泳15 min、30 min、50 min后分别随机选取10只小鼠,致死,眼眶采血并测定血清中ALT、AST和ALP活性。结果表明:15 min游泳应激使小鼠血清ALT和AST活性显著升高(P<0.05),应激30 min和50 min后ALT活性显著下降(P<0.05),但仍显著高于游泳前(P<0.05);而AST活性在应激30 min后继续维持高水平,50 min后又显著下降(P<0.05),但仍显著高于游泳前水平(P<0.05)。15 min游泳应激使小鼠ALP活性略有上升,但差异不显著(P>0.05);应激30 min后显著升高(P<0.05);应激50 min后继续维持较高水平。说明游泳应激可能造成小鼠肝脏、心脏、肌肉等组织器官损伤,血清ALT、AST和ALP活性可作为评价小鼠应对游泳应激的敏感指标。

2009-2013年郑州市无偿献血者中ALT不合格率分析

目的对本市无偿献血者丙氨酸氨基转移酶(ALT)不合格率进行分析,以探讨所采取的应对措施是否有效。方法对2009-2013年本市858 772份无偿献血者标本ALT检测结果进行回顾性分析。结果 ALT不合格者27 579份,总体不合格率为3.21%;ALT不合格率以2011年(4.72%)最高,2013年(1.69%)最低,ALT不合格率不同年份间比较差异有统计学意义(P<0.01)。男性献血者ALT不合格率(4.80%)明显高于女性(1.03%,P<0.01);ALT不合格率以26-35岁年龄段最高(4.84%,P<0.01)。ALT不合格率的高低有一定的季节性,秋季最高(4.37%,P<0.01)。ALT不合格人群的HBs Ag、抗-HCV阳性率为1.61%,而在ALT合格人群中HBs Ag、抗-HCV阳性率仅为0.80%,前者明显高于后者(P<0.01)。ALT升高与HBV、HCV的病毒感染呈低度相关(P<0.01,r=0.006;P<0.01,r=0.016)。结论加强献血前征询和教育,选择低危献血者,同时加强献血前ALT的初筛并合理运用ALT检测方案,可有效减少因ALT不合格而导致的血液资源浪费。

实施核酸检测后重新评估献血者ALT的检测功效

目的引入核酸检测后,重新评估ALT对血液安全的功效,为优化血液筛查策略提供依据。方法对2010年11月-2015年12月近5年时间北京市红十字血液中心1 495 863例无偿献血者进行ALT与乙肝标志物(HBs Ag、HBV-DNA)、丙肝标志物(抗-HCV、HCV-RNA)检测结果分析,评估ALT在肝炎方面对于血液安全的功效。结果 1)ALT不合格献血者的乙肝检出率(5.950‰)略高于ALT正常献血者(3.720‰),ALT不合格献血者的丙肝检出率(1.386‰)略低于ALT正常献血者(4.428‰),差异有统计学意义(χ2值分别为10.60、156.04,P<0.01)。2)ALT不合格献血者的HBV-DNA单阳性检出率、HCV-RNA单阳性检出率与ALT正常献血者均无显著差异(χ2值分别为0.017、0.086,P>0.01)。3)使用百分位数法计算3 642例献血者ALT95%界限为59 U/L。4)采用不同ALT判定界值(40 U/L、50 U/L、59 U/L),692例HBV-DNA单阳性献血者检出率无统计学差异(χ2=4.502,P>0.01)、16例HCV-RNA单阳性献血者均不能检出。5)ALT判定界值从40 U/L调整为50 U/L时,平均每年增加2.19%血液资源;如ALT判定界值从50 U/L提升至59 U/L,至少可节约74.11%单纯因ALT不合格的血液。结论开展核酸检测以来显著提升了血液安全,ALT对降低输血传播风险的功效已极其有限,研究支持取消ALT检测。在目前政策下,可适当将ALT判定界值调整为59 U/L,在确保血液安全的前提下获得更多的资源。

献血者血清ALT活性的研究

目的评估献血者血清丙氨酸转氨酶(ALT)活性参考范围及在献血员筛选中的意义。方法对血清标志物HBsAg、HIV蛳Ab1/2、anti蛳TP阴性的无偿献血者7332例进行HCV蛳Ab检测(酶联免疫吸附法)及血清ALT活性检测(连续监测法),并对数据进行统计学分析。结果7262例HCV蛳Ab阴性无偿献血者的血清ALT活性呈偏态分布,中位数为13U/L,第5、25、75、95百分位数分别为7、10、20、49U/L。无偿献血者的血清ALT活性在不同性别间有非常显著性差异(P<0.01),男性高于女性。男性、女性以及全部无偿献血者在不同年龄组之间血清ALT活性均有非常显著性差异(P<0.01),并且随年龄增长而升高,男性40岁后有下降趋势,但无显著性差异(P>0.05)。全部7332例无偿献血者中HCV蛳Ab阳性者70例,ALT>40U/L者527例,ALT>40U/L且HCV蛳Ab阳性者10例,仅占HCV蛳Ab阳性者的14.3%(10/70),占ALT>40U/L者的1.9%(10/527)。结论无偿献血人群中血清ALT活性呈偏态分布,第95百分位数血清ALT活性为49U/L,存在性别及年龄差异,血清ALT活性已逐渐失去作为筛选非甲非乙型肝炎无偿献血者替代指标的意义。

湛江师范学院2010级新生血清AST、ALT及AST/ALT的检测结果分析

目的通过对湛江师范学院2010级新生血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及AST/ALT进行检测,在健康新生中筛查肝功能异常及无症状慢性乙型肝炎。方法采用日立7020全自动生化仪测定2010级新生血清中AST、ALT及AST/ALT的变化,并对AST、ALT异常的新生进行乙型肝炎两对半的检测。结果检测出血清ALT和AST异常者42例,占0.80%。无症状慢性乙型肝炎56例,占1.06%。血清ALT和AST升高者,男生高于女生,差异有统计学意义(χ2=9.50,P<0.01);AST/ALT升高者,男生高于女生,差异也有统计学意义(χ2=6.63,P<0.01);慢性乙型肝炎男生高于女生,差异有统计学意义(χ2=10.67,P<0.01),3项结果差异均有统计学意义。结论在新生体检中进行血清AST、ALT及AST/ALT检测,并对肝功能异常者进行乙型肝炎两对半检测,有利于肝功能异常及无症状慢性乙型肝炎的早期发现和诊治。男生血清AST和ALT、AST/ALT、慢性乙型肝炎异常者高于女生,应引起足够重视。

重庆市无偿献血者ALT正常值上限的分析与不合格率的探讨

目的调查重庆市无偿献血者血浆丙氨酸氨基转移酶(ALT)的正常值上限,为最大限度的避免因ALT不合格而造成的血液报废提供科学依据和改进措施。方法用速率法检测115 530名无偿献血者ALT,ALT活性值呈正态分布,采用x±1.96s作为正常值上限,对无偿献血者ALT正常上限值和不合格率按月份、年龄、性别进行统计分析。结果无偿献血者的ALT上限值95%的参考范围为不高于47.88U/L。6~9月ALT值的不合格率与其他月份比较差异有统计学意义(P<0.05);不同年龄间正常值上限和不合格率比较差异无统计学意义(P>0.05);不同性别间正常值上限和不合格率比较差异有统计学意义(P<0.05)。结论采供血机构应加大宣传力度,优化ALT筛查策略,应针对不同性别的无偿献血者采取相应的筛选措施,重新建立更科学的ALT淘汰标准,最大限度降低血液的ALT不合格率。在保证该地区血液安全及临床供应的同时,最大限度地避免血液浪费。

ALT单项不合格献血者献血情况跟踪调查分析

目的了解ALT单项检测不合格献血者的归队情况,及再次献血的ALT检测情况。方法选取2009年3月至2010年2月ALT单项不合格的献血者3 784例,并对其之前的献血情况进行调查。对该人群进行为期3年的归队再献血情况跟踪调查和统计分析。结果 3 784例ALT不合格献血者中首次参加无偿献血的占58.14%(2 201/3 748)。3年的跟踪调查发现,重新归队献血者所占比例为33.62%(1 272/3 784);1年内重新归队的献血者比例最高,占重新归队献血者的46.62%;ALT合格的献血者占总归队人数的65.72%(836/1 272),随着献血次数增加,ALT合格率也相应增加。结论 ALT单项检测不合格的献血者归队人数过半,其中有较大比例的归队献血者多次参加了无偿献血,且ALT合格率随着献血次数的增加而增高。为降低ALT不合格率应注重加强献血知识的宣传和固定献血队伍的建设。

乙肝病毒载量与血清标志物及ALT相关性研究

探讨了乙型肝炎病毒核酸(HBV-DNA)水平与乙型肝炎免疫标志物(HBVM)和丙氨酸氨基转移酶(ALT)的关系。分别采用实时荧光定量聚合酶链反应(FQ-PCR),酶联免疫法和连续监测法检测了345例血清标本HBV-DNA含量,HBVM(HBsAg、HBsAb、HBeAg、HBeAb、抗HBcIgM)表达及ALT水平。HBsAg、HBeAg(和抗HBcIgM)阳性患者HBV DNA阳性率要明显高于HBsAg、HBeAb(和抗HBcIgM)阳性患者、仅HBsAg阳性患者及HBsAb、HBeAb阳性患者(P<0.01)。血清HBeAg阳性标本HBV-DNA阳性率为98.7%,明显高于HBeAg阴性标本的61.6%(P<0.01),并且血清HBeAg阳性标本HBV-DNA含量(log值,7.42±1.43)也明显高于HBeAg阴性标本(4.36±1.73)(P<0.01);在HBV-DNA含量小于107copy/mL的标本中,ALT与HBV-DNA含量呈正相关(P<0.01)。血清中HBV DNA含量与乙型肝炎免疫标志物以及肝细胞损伤三者之间存在密切的关系,在临床工作中应对血清HBVM、ALT和HBV-DNA含量联合检测,这样才能更准确地判断患者病情、预后及指导抗病毒药物的应用。

血清ALT活性参考区间再评价

目的 血清丙氨酸氨基转移酶 (ALT EC 2 6 ,1 2 )活性是评价肝细胞损伤的一个重要指标。本研究探讨分析ALT活性参考区间的再评价。方法 选择HBsAg ,Anti HCV标志物均为阴性的 2 84 9名健康人和献血员作为研究对象。采用连续监测技术对全部 2 84 9名研究对象进行了血清ALT活性测定 ,又在其中随机选取 6 85名进行了赖氏法测定ALT活性。结果 血清ALT的测定值在各年龄组无显著性差异 ;男性明显高于女性 ,具有明显的统计学差异 (连续监测法 :P <0 .0 0 1;赖氏法 :P <0 .0 5或P <0 .2 0 )。 2 84 9名ALT连续监测法测定值的第百分之 95位点为 5 3.4 9U/L ,第百分之 99位点为 6 6 .5 9U/L ;随机选取的 6 85名ALT赖氏法测定值第百分之 95位点为 2 4 96单位 ,第百分之 99位点为38 89单位。结论 参照赖氏法参考区间 ,ALT连续监测法参考区间上限应该为 5 3 4 9U/L。