Serum Gamma-glutamyl Transferase Levels Predict Functional Outcomes after Aneurysmal Subarachnoid Hemorrhage

Objective We aim to explore the potential association between serum gamma-glutamyl transferase levels and functional outcome after aneurysmal subarachnoid hemorrhage in a Chinese population. Methods A total of 386 aneurysmal subarachnoid hemorrhage patients were included in the study from September 2007 to February 2015. Baseline serum gamma-glutamyl transferase levels and 6-month follow-up functional outcomes were determined. A poor outcome was defined as a modified ranking scale score of ≥ 3. The multivariable logistic model was used to analyze the relationship between serum gamma-glutamyl transferase and clinical outcomes after aneurysmal subarachnoid hemorrhage. Results The adjusted poor outcome rates of patients with gamma-glutamyl transferase levels of 〈 30 U/L, 30-50 U/L and ≥ 50 U/L were 16.7%, 19.6%, and 34.4%, respectively （P 〈 0.01）. The age-sex and multivariable adjusted odds ratios （95% confidence intervals） of poor prognosis comparing the top group （≥ 50 U/L） with the lowest group （〈 30 U/L） were 5.76 （2.74-12.13）, 6.64 （2.05-21.52）, and 6.36 （1.92-21.02）. A significant linear trend existed between gamma-glutamyl transferase level and aneurysmal subarachnoid hemorrhage prognosis. This association was also observed among nondrinkers. Conclusion Patients with higher gamma-glutamyl transferase levels were more likely to have a poor prognosis. Serum gamma-glutamyl transferase can be considered to be an independent predictor of functional outcomes after aneurysmal subarachnoid hemorrhage.

Association of serum gamma-glutamyl transferase with treatment outcome in chronic hepatitis B patients

AIM:To investigate the association of serum gammaglutamyl transferase(GGT) levels with chronic hepatitis B infection and hepatitis B e antigen(HBe Ag) seroconversion.METHODS:A retrospective study was performed on clinical data collected from patients who had been positive for hepatitis B surface antigen for > 6 mo and who were antiviral-treatment na?ve(n = 215) attending the Hepatitis Clinic at Nanjing Drum Tower Hospital between August 2010 and December 2013. Healthy individuals without liver disease(n = 83) were included as controls. Patients were categorized into four groups based on disease status as recommended by the European Association for the Study of the Liver:immune tolerance(IT; n = 47),HBe Ag-positive hepatitis(EPH; n = 93),HBe Ag-negative hepatitis(ENH;n = 20),and inactive carrier(IC; n = 55). Prediction of complete response(CR) based on serum GGT was also examined in EPH patients(n = 33) treated for 48 wk with nucleos(t)ide analogue(NA) therapy,including lamivudine plus adefovir combination therapy(n = 20) or entecavir monotherapy(n = 13). CR was defined as a serum hepatitis B virus DNA level < 500 copies/m L and HBe Ag seroconversion by 48 wk of treatment. RESULTS:Serum GGT levels were significantly increased in EPH and ENH patients relative to the IT,IC,and healthy control groups(P < 0.01 for all). However,no significant difference in serum GGT levels was found between the EPH and ENH groups. Baseline serum GGT levels were significantly higher in patients who achieved CR(7/33; 21.2%) compared to patients in the non-CR group(26/33; 78.8%; P = 0.011). In addition,the decline in serum GGT was greater in CR patients compared to non-CR patients after 24 wk and 48 wk of treatment(P = 0.012 and P = 0.008,respectively). The receiver operating characteristic curve yielded a sensitivity of 85.71% and a specificity of 61.54% at a threshold value of 0.89 times the upper limit of normal for baseline serum GGT in the prediction of CR following NA therapy. CONCLUSION:Serum GGT is significantly elevated in EPH and ENH patients and is a potential biomarker for the prediction of HBe Ag seroconversion following NA therapy.

Gamma-glutamyl transferase and cardiovascular risk in nonalcoholic fatty liver disease:The Gut and Obesity Asia initiative

BACKGROUND Gamma-glutamyl transferase(GGT)is associated with the risk of cardiovascular disease(CVD)in the general population.AIM To identify the association of baseline GGT level and QRISK2 score among patients with biopsy-proven nonalcoholic fatty liver disease(NAFLD).METHODS This was a retrospective study involving 1535 biopsy-proven NAFLD patients from 10 Asian centers in 8 countries using data collected by the Gut and Obesity in Asia(referred to as“GO ASIA”)workgroup.All patients with available baseline GGT levels and all 16 variables for the QRISK2 calculation(QRISK2-2017;developed by researchers at the United Kingdom National Health Service;https://qrisk.org/2017/;10-year cardiovascular risk estimation)were included and compared to healthy controls with the same age,sex,and ethnicity.Relative risk was reported.QRISK2 score>10%was defined as the high-CVD-risk group.Fibrosis stages 3 and 4(F3 and F4)were considered advanced fibrosis.RESULTS A total of 1122 patients(73%)had complete data and were included in the final analysis;314(28%)had advanced fibrosis.The median age(interquartile range[IQR])of the study population was 53(44-60)years,532(47.4%)were females,and 492(43.9%)were of Chinese ethnicity.The median 10-year CVD risk(IQR)was 5.9%(2.6-10.9),and the median relative risk of CVD over 10 years(IQR)was 1.65(1.13-2.2)compared to healthy individuals with the same age,sex,and ethnicity.The high-CVD-risk group was significantly older than the low-risk group(median[IQR]:63[59-67]vs 49[41-55]years;P<0.001).Higher fibrosis stages in biopsy-proven NAFLD patients brought a significantly higher CVD risk(P<0.001).Median GGT level was not different between the two groups(GGT[U/L]:Median[IQR],high risk 60[37-113]vs low risk 66[38-103],P=0.56).There was no correlation between baseline GGT level and 10-year CVD risk based on the QRISK2 score(r=0.02).CONCLUSION The CVD risk of NAFLD patients is higher than that of healthy individuals.Baseline GGT level cannot predict CVD risk in NAFLD patients.However,advanced fibrosis is a predictor of a high CVD risk.

TBil、APRI联合GGT/Alb比值对胆道闭锁患儿肝纤维化严重程度的诊断价值

目的:探讨总胆红素(TBil)、天冬氨酸氨基转移酶/血小板比值指数(APRI)联合γ-谷氨酰转肽酶(GGT)/白蛋白(Alb)比值在诊断胆道闭锁(BA)患儿肝纤维化严重程度中的价值。方法:选取2021年9月至2023年9月于郑州大学附属儿童医院确诊且住院手术的BA患儿120例为研究对象,依据肝纤维化严重程度分为<F2期组和≥F2期组,记录患儿一般资料及临床指标。结果:≥F2期组患儿TBil、APRI、GGT/Alb比值、天冬氨酸氨基转移酶(AST)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-Col)、透明质酸(HA)、层黏蛋白(LN)显著高于<F2期组患儿(P<0.05)。BA患儿TBil、APRI、GGT/Alb比值与AST、PCⅢ、Ⅳ-Col、HA、LN均呈正相关(P<0.05)。TBil、APRI、GGT/Alb比值是BA患儿发生明显肝纤维化的独立危险因素(OR=2.939、2.873、2.895,P<0.05)。TBil、APRI、GGT/Alb比值单独及联合诊断的曲线下面积分别为0.837、0.841、0.851、0.956。结论:TBil、APRI、GGT/Alb比值联合在诊断BA患儿肝纤维化程度方面具有重要价值。

Oxidative stress-elevated high gamma glutamyl transferase levels, and aging, intake of tropical food plants, migration and visual disability in Central Africans

·AIM:To investigate the independent pathogenic role of high serum gamma-glutamyl transferase (GGT) levels, sociodemographic data, dietary and environmental risk factors for visual disability (VD). ·METHODS:This was a case-control study, run in 200 black Congolese patients managed in Saint Joseph Hospital Ophthalmology Division from Kinshasa town. Logistic regression model was used to identify determinants of VD (n = 58) among sex, age, cigarette smoking, alcohol abuse, rural-urban migration, education levels, aging ≥60 years, intake of red Beans, Safou fruit and Taro leaves, lipid profile, residence, socioeconomic status, and GGT. ·RESULTS:After adjusting for confounding factors, we identified migration (OR=3.7 95% CI:1.2-11.3; P =0.023), low education level (OR=3.1 95% CI 1.1-8.5; P =0.026), no intake of Safou fruit (OR=34.2 95% CI 11.5-102; P < 0.0001), age ≥60 years (OR=2.5 95% CI 1.01-6.5; P = 0.049), and serum GGT ≥10U/L (OR=3.6 95% CI 1.3-9.6; P = 0.012) as the significant and independent determinants of VD. ·CONCLUSION:VD appears as a major public health problem in Central Africa to be prevented or delayed by control of migration, lifestyle changes, antioxidant supplements, appropriate diet, nutrition education, and blocking of oxidative stress.

The Micro-determination of Serum Gamma-Glutamyl Transferase

The method of serum gamma-glutamyl transferase colorimeter assay was modified by changing the wave length from 420 nm to 400 nm, the incubated temperature from 37℃ to 50℃, the sample amount from 30 μl to 6μl. The modified method was proved to be more sensitive, with CV of intra-group being 2. 06% and accuracy 97. 4%. The method is suitable for clinical application with small-amount blood samples collected frorri earlobe or finger tip.

Effect of <i>Lactobacillus brevis</i>SBC8803 on Gamma-Glutamyl Transferase in Japanese Habitual Drinkers: A Double-Blind, Placebo-Controlled Study

A randomized, double-blind, placebo-controlled clinical trial in Japanese habitual drinkers was conducted to evaluate the efficacy of Lactobacillus brevis SBC8803 to alleviate adverse effect of alcohol. Subjects who drank habitually and had moderately higher levels of gamma-glutamyl transferase (GGT) (50 - 100 IU/L) were enrolled. The levels of transaminases in these subjects were almost within normal levels (aspartate transaminase (AST) <30 IU/L and alanine transaminase (ALT) <40 IU/L). Either the capsules containing placebo (n = 23) or 130 mg (4.0 × 1010 colony-forming units) of live L. brevis SBC8803 (n = 22) per day were administered for the continuous eight weeks (56 days). During the period, the subjects both in test group and placebo groups have kept each drinking behavior as usual. Regarding lipid metabolism, triacylglycerol (TG) levels in the male test group significantly decreased at week 4 as compared with week 0. Biomarkers of hepatocytes-damage;AST and ALT levels showed no significant differences between the pla- cebo and test groups at both weeks 4 and 8. Oxidative stress marker;GGT at weeks 4 was significantly lower in the test group than that in the placebo group (p = 0.017), but not at weeks 8. However, taking a reduced rate of GGT at weeks 8 comparing with that at week 0, that in the test group showed larger value comparing with that in the placebo group. These data about TG and GGT suggest that, although efficacy of L. brevis SBC8803 is limited in this study, intake of the probiotic may alleviate alcoholic influence in lipid metabolism and oxidative stress.

基于术前血清学指标AFP和GGT的标准在预测肝细胞癌患者肝移植术后长期生存中的作用研究

目的分析术前血清学指标对肝细胞癌(HCC)患者肝移植术后长期生存和肿瘤复发的预测作用,探索其对扩大米兰标准的意义。方法回顾性分析669例HCC肝移植受者的临床资料,采用受试者工作特征(ROC)曲线计算最佳截取值,采用单因素和多因素回归分析影响HCC患者肝移植术后总生存率和无复发生存率的危险因素,分析术前血清肝酶与肿瘤病理学特征的相关性,比较甲胎蛋白(AFP)联合γ-谷氨酰转移酶(GGT)以及不同肝移植标准对HCC患者肝移植术后生存和复发的预测价值。结果超米兰标准、肿瘤直径之和(TTD)>8 cm、AFP>200 ng/mL和GGT>84 U/L是影响HCC患者肝移植术后总生存率和无复发生存率的独立危险因素(均为P<0.05)。相关性分析结果显示,术前血清GGT水平与TTD,肿瘤数量,静脉侵犯,微卫星病变,包膜侵犯,肿瘤、淋巴结、转移(TNM)分期,Child-Pugh评分,超米兰标准均存在相关性(均为P<0.05)。将米兰标准、TTD与血清肝酶指标(AFP和GGT)结合,提出Milan-AFP-GGT-TTD(M-AGT)标准。符合M-AGT标准者(其中111例超米兰标准)术后5年总生存率和无复发生存率均高于符合杭州标准者(均为P<0.05),与符合加州大学旧金山分校(UCSF)标准者的术后5年总生存率和无复发生存率比较差异均无统计学意义(均为P>0.05)。结论术前血清学指标AFP和GGT可有效预测HCC患者肝移植术后长期生存和肿瘤复发,建立基于血清学指标的M-AGT标准有助于补充米兰标准,且简单易行。

血清PTX-3、γ-GGT与冠心病及冠脉狭窄程度的相关性分析

目的探讨正五聚蛋白3(pentraxin,PTX-3)和γ-谷氨酰转肽酶(gamma-glutamyl transferase,γ-GGT)在评估冠心病(Coronary Heart Disease,CHD)及冠状动脉狭窄程度的潜在价值,评估两者联合检测对CHD早期诊断的临床意义.方法通过冠状动脉造影(CAG)定量测量Gensini(GS)评分方法评价冠脉狭窄程度.选取75例首次行CAG确诊为CHD的患者为试验组(CHD组),同时选取30例CAG结果阴性的患者为对照组,其中试验组根据GS评分系统依次分为低分组(24例)、中分组(24例)及高分组(27例).入院后采取酶联免疫吸附法(ELISA法)测定PTX-3水平,应用全自动生化分析仪检测所有纳入研究患者的血清γ-GGT水平,比较各组血清PTX-3、γ-GGT水平差异及两者联合检测对CHD早期诊断和冠脉狭窄程度的价值.结果随着CHD冠脉狭窄程度的增高,血清PTX-3、γ-GGT水平依次升高,即高分组>中分组>低分组>对照组(P<0.001).结论PTX-3、γ-GGT在CHD患者血清中显著升高,且与GS评分呈显著正相关关系;PTX-3、γ-GGT联合检测有可能成为冠心病早期诊断和危险分度的血清学标志物.

TBA、ALB、TC、CHE、GGT应用于肝炎肝硬化患者检验中的作用分析

目的分析总胆汁酸(total bile acid,TBA)、白蛋白(albumin,ALB)、总胆固醇(total cholesterol,TC)、血胆碱酯酶(cholinesterase,CHE)、γ-谷氨酰转移酶(gamma-glutamyl transferase,GGT)应用于肝炎肝硬化(viral hepatitis cirrhosis,VHC)患者检验中的作用。方法选取2019年1月—2022年12月盐城市第一人民医院检验科收治的90例VHC患者为观察组,另选取同期80例健康体检人群为对照组,对比两组肝功能指标、分析不同分级患者肝功能指标,肝功能指标评估VHC的价值。结果观察组ALB水平低于对照组,观察组TBA、TC、CHE、GGT水平高于对照组,差异有统计学意义(P<0.05)。C级患者TBA、TC、CHE、GGT水平均高于B级、A级,ALB水平均低于B级、A级,差异有统计学意义(P<0.05)。TBA、ALB、TC、CHE、GGT灵敏度、特异度分别为96.20%、87.80%;80.00%、91.10%;95.00%、81.10%;95.00%、81.10%;96.20%、90.00%。且TBA、ALB、TC、CHE、GGT预测VHC发生价值较高(AUC>0.9)。结论对VHC患者行TBA、ALB、TC、CHE、GGT检测,对患者肝脏损伤程度及预后具有评估及预测价值,对临床诊断、病情评估具有重要影响。

阿尔茨海默病患者血清GGT、CTHRC1表达水平检测及临床意义

目的 研究阿尔茨海默病(AD)患者血清γ-谷氨酰转移酶(GGT)和胶原蛋白三螺旋重复蛋白1(CTHRC1)表达及临床意义。方法 以120例AD患者为AD组,以同期体检健康者60例为对照组。采用酶联免疫吸附试验检测各组血清GGT和CTHRC1表达及肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6,采用免疫比浊法检测血清超敏C反应蛋白(hs-CRP)水平。Pearson相关分析AD组血清GGT、CTHRC1表达与TNF-α、IL-1β、IL-6、CRP及简明精神状态量表(MMSE)评分的相关性。多因素Logistic回归分析影响AD发生的危险因素。受试者工作特征曲线分析血清GGT、CTHRC1水平对AD的诊断价值。结果 AD组患者血清GGT、CTHRC1、TNF-α、IL-6、IL-1β及hs-CRP水平高于对照组,MMSE评分明显低于对照组(均P<0.05)。AD组患者血清GGT、CTHRC1表达与TNF-α、IL-6、IL-1β及hs-CRP水平呈正相关,与MMSE评分呈负相关(均P<0.05)。GGT、CTHRC1水平升高及MMSE评分降低是影响AD发生的独立危险因素(P<0.05)。血清GGT和CTHRC1单独及联合检测诊断AD的曲线下面积(95%CI)分别为0.780(0.726~0.836)、0.728(0.705~0.810)、0.909(0.875~0.942)。联合检测对AD的诊断价值高于血清GGT和CTHRC1(Z分别为4.370和5.657,P<0.05)。结论 AD患者血清GGT和CTHRC1表达水平与患者炎症反应及认知程度有关,两者联合检测对AD具有较高的诊断价值。

肝功能相关指标联合胆囊收缩率在诊断胆道闭锁中的应用价值

目的探讨γ-谷氨酰转移酶(gamma-glutamyl transferase,GGT)、直接胆红素(direct bilirubin,DBil)与胆囊收缩率在诊断胆道闭锁(biliary atresia,BA)中的应用价值。方法收集2017年9月至2021年9月在西安交通大学附属儿童医院及西安市中心医院儿科住院治疗的185例胆汁淤积性肝病患儿为研究对象,根据剖腹探查或术中胆道造影和随访情况,将患儿分为BA组(70例)和肝内胆汁淤积(intrahepatic cholestasis,IHC)组(115例)。比较两组患儿的一般临床资料、实验室检查指标[包括总胆红素(total bilirubin,TBil)、DBil、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、GGT、碱性磷酸酶(alkaline phosphatase,ALP)、总胆汁酸(total bile acid,TBA)]及腹部超声检查资料。将有统计学意义的指标纳入受试者工作特征(receiver operator characteristic,ROC)曲线分析,计算ROC曲线下面积、最佳诊断界值和OR值;应用MedCalc软件进行ROC曲线下面积对比,分析各指标对诊断BA的价值。结果BA组和IHC组患儿的性别(男/女:31例/39例比78例/37例)、就诊年龄(中位数:52.0 d比58.0 d)、肝脏肋下大小(中位数:4.0 cm比2.0 cm)、脾大比例[40%(28/70)比18.3%(21/115)]、大便颜色、TBil(中位数:204.35μmol/L比138.30μmol/L)、DBil(中位数:125.70μmol/L比80.00μmol/L)、ALT(中位数:112.00 U/L比71.00 U/L)、AST(中位数:175.00 U/L比120.00 U/L)、GGT(中位数:440.75 U/L比94.50 U/L)、餐后1 h胆囊收缩率(无收缩/有收缩且<50%/有收缩且>50%:52.9%/41.4%/5.7%比7.0%/27.8%/65.2%)差异有统计学意义(P均<0.05)。两组患儿ALP(中位数526.00 U/L比548.00 U/L)、TBA(中位数:143.45μmol/L比161.90μmol/L)和25羟维生素D(中位数:8.00 ng/ml比8.13 ng/ml)水平差异无统计学意义(P均>0.05)。多因素Logistic回归分析表明,DBil(OR=1.031,95%CI:1.015~1.047,P<0.001)、GGT(OR=1.007,95%CI:1.004~1.011,P<0.001)、餐后1 h胆囊无收缩(OR=57.493,95%CI:9.577~345.133,P<0.001)和胆囊收缩率<50%(OR=9.907,95%CI:1.828~53.710,P=0.008)均为BA的危险因素。TBil、DBil、ALT、AST、GGT、GGT+DBil、GGT+DBil+胆囊收缩率诊断BA的ROC曲线下面积分别为0.797、0.820、0.614、0.658、0.890、0.932和0.963。单项指标中GGT的ROC曲线下面积最大,当GGT超过界值173.20 U/L时诊断BA的敏感度、特异度、阳性似然比、阴性似然比和诊断比值比分别为84.3%、78.3%、3.885、0.201和19.328。GGT+DBil+胆囊收缩率联合对BA的诊断价值最高,ROC曲线下面积显著高于GGT+DBil(z=2.303,P=0.021),其诊断BA的敏感度、特异度、阳性似然比、阴性似然比和诊断比值比分别为90.0%、90.4%、9.375、0.111和84.459。结论GGT、DBil与胆囊收缩率联合对BA有较高的诊断价值,当GGT超过界值173.20 U/L、DBil超过界值97.05μmol/L且超声提示胆囊收缩不良时需高度警惕BA。

血清镁离子浓度与直肠癌患者谷氨酰转肽酶的关系

直肠癌患者血清镁离子(Mg^(2+))浓度对γ-谷氨酰转肽酶(γ-GT)的影响尚不明确,收集分析临床数据,Mg^(2+)浓度不呈正态分布(D=0.737,P<0.05),按照中位数分组,比较不同组间临床病理特征的差异,用局部加权散点平滑(LOWESS)、分段线性回归方法,拟合血清Mg^(2+)浓度与γ-GT的关系。结果发现,与Mg^(2+)浓度小于0.92 mmol/L组的直肠癌患者比较,Mg^(2+)浓度≥0.92 mmol/L组的γ-GT和血清总胆固醇较高(P均<0.05)。LOWESS的结果表明,原始数据中血清Mg^(2+)浓度的两个变化点分别为0.92 mmol/L和0.99 mmol/L,自然对数转换的数据中血清Mg^(2+)浓度的另外两个变化点分别为-0.167和-0.01。利用原始数据建立的两段线性回归模型表明,血清Mg^(2+)浓度的变化点为0.98 mmol/L,Mg^(2+)浓度<0.98 mmol/L对γ-GT有正向影响,Mg^(2+)≥0.98 mmol/L时有负向影响。另一个使用自然对数转换数据的两段线性回归模型显示,血清Mg^(2+)浓度的变化点为0.01,其中Mg^(2+)浓度的自然对数<0.01对γ-GT有正向影响,当Mg^(2+)浓度的自然对数≥0.01时则有负向影响。用原始数据LOWESS回归的2个拐点,即0.92 mmol/L和0.99 mmol/L的Mg^(2+)浓度,进行三段线性回归分析,结果显示,<0.980 mmol/L的Mg^(2+)浓度,对γ-GT的影响是正向的,且与<0.929 mmol/L的Mg^(2+)浓度区间的系数不同,影响程度不同,而在≥0.980 mmol/L的Mg^(2+)浓度区间,对γ-GT的影响是负向的,此外,用对数转换数据LOWESS的2个拐点进行的三段线性回归,也显示Mg^(2+)浓度的自然对数以-0.020为分界点时,对γ-GT的影响方向是相反的,但三段线性回归模型均没有统计学意义,总之,具有较高Mg^(2+)浓度的直肠癌患者,其γ-GT的水平也较高,Mg^(2+)浓度对γ-GT的影响存在拐点效应,为γ-GT的关联因素研究提供了基础。

联合检测血清AFP，HCY和GGT对原发性肝细胞癌的诊断价值

目的探讨联合检测甲胎蛋白（AFP）、同型半眺氨酸（HcY）和r谷氨酰转移酶（GGT）在原发性肝细胞癌（HCC）中的诊断价值。方法共收集226例血清标本，其中原发性肝细胞癌（HCC）组患者血清99例，慢性肝病（慢肝）组70例，健康对照（对照）组57例；采用微粒子酶联免疫法、循环酶法和酶动力学法分别测定血清AFP，HCY和GGT浓度；SPSS统计学方法分析AFP，HCY和GGT及联合检测对HCC的诊断价值。结果HCC组血清AFP，HCY和GGT的浓度明显高于慢肝组和对照组，差异有统计学意义（P〈0．01）。血清AFP，HCY和GGT诊断HCC受试者工作特征曲线（ROC曲线）下面积（AUc）为AFP（0．823）〉HCY（0．803）〉GGT（0．775），诊断效能AFP〉HCY〉GGT。各指标单项检测时敏感度及准确度HCY〉GGT〉AFP，特异度AFP〉HcY〉GGT。AFP联合HcY与GGT，敏感度及特异度AFP＋HCY〉AFP＋GGT。三项指标联合检测敏感度明显升高（90．90％），但特异度下降明显（62．20％）。结论AFP，HCY和GGT两两联合和三项联合检测，优于AFP单项指标检测，可以显著提高HCC的阳性检出率。

肝癌特异性 GGT 的发生及其定量分析的临床价值

目的探讨肝癌特异性ＧＧＴ的动态变化及其定量分析的临床价值。方法以化学致癌剂２－ＦＡＡ（００５％）制备鼠肝癌模型，观察肝癌ＧＧＴ的产生及其肝组织内分布，并对不同肝病患者血清肝癌特异性ＧＧＴ区带（ＨＳＢ）进行定量分析研究。结果在实验性鼠的诱癌过程中，鼠肝脏癌变组织中ＧＧＴ大量表达，出现早并具有胎肝ＧＧＴ的特点；人血清中ＨＳＢ的定量检测发现：肝癌组明显高于其他肝病组，肝外肿瘤及正常对照组（Ｐ＜０００１）；ＨＳＢ在小肝癌中的阳性率为７５％，在ＡＦＰ阴性肝癌中为７８３％。结论研究资料提示ＨＳＢ的定量检测其临床价值优于ＨＳＢ的定性分析，且有助于小肝癌和ＡＦＰ阴性肝癌的早期诊断。

HS-AFP GGT-Ⅱ及AFP预测肝硬化癌变的临床价值

目的:探讨肝癌特异性甲胎蛋白(HS-AFP)、甲胎蛋白(AFP)和γ-谷氨酰转肽酶同工酶Ⅱ(GGT一Ⅱ)对肝硬化患者肝癌发生风险的预警价值。方法:HS-AFP采用聚丙烯酰胺凝胶电泳技术(PAGE)结合Western blot分离检测。AFP采用放射免疫分析测定法。GGT-Ⅱ采用PAGE分离检测。对341例肝硬化患者进行跟踪随访18个月,了解肝癌发生情况,分析比较HS-AFP、GGT-Ⅱ和AFP预测肝硬化患者发生肝癌风险的价值。结果:6、12、18个月随访期内HS-AFP、GGT-Ⅱ两项指标阳性组癌变率高于阴性对照组;随访12个月以上AFP阳性组癌变率高于阴性对照组;Hs-AFP、GGT-Ⅱ阳性组癌变率高于AFP阳性组,但前两者差异不明显;HS-AFP与GGT-Ⅱ及AFP之间存在互补性,其中HS-AFP和GGT-Ⅱ联合检测预测肝硬化癌变的敏感性、特异性和准确度分别达71.6%、91.4%、91.6%。结论:HS-AFP、GGT-Ⅱ和AFP对肝硬化癌变均有预测价值;HS-AFP和GGT-Ⅱ预测肝癌的特异性、准确度优于AFP;HS-AFP与GGT-Ⅱ预测肝癌的特异性、准确度相似;多项指标联合检测可提高预测肝硬化癌变的敏感性、特异性和准确度,以HS-AFP和GGT-Ⅱ联合检测效果最优。

AFP、GGT、GP73联合诊断早期原发性肝癌的价值研究

目的探讨甲胎蛋白(AFP)、谷氨酰转肽酶(GGT)、高尔基体糖蛋白(GP73)联合诊断早期原发性肝癌的价值。方法选取该院2015年6月至2017年6月收治的原发性肝癌患者109例作为原发性肝癌组,肝硬化患者76例作为肝硬化组,健康体检者70例作为对照组。各组分别于清晨空腹抽取外周静脉血,分离血清,采用酶联免疫吸附法测定GP73的水平,采用化学发光免疫法测定AFP水平,采用速率法测定GGT水平。结果原发性肝癌组血清AFP、GGT、GP73水平高于肝硬化组和对照组,且肝硬化组血清AFP、GGT、GP73水平高于对照组,差异均有统计学意义(P<0.05);AFP、GGT、GP73联合诊断的特异度和灵敏度高于AFP、GGT、GP73单项诊断。结论 AFP、GGT、GP73联合诊断早期原发性肝癌具有重要价值,具有较高的灵敏度和特异度,值得临床进一步研究。

3137例体检人群血清GGT水平和血脂指标的相关性研究

目的探讨体检人群γ-谷氨酰基转移酶(gamma-glutamyl transferase,GGT)升高与血脂代谢异常的相关性。方法选取2020年4月至2021年8月3137例体检者作为研究对象,采集基线资料、GGT和血脂代谢指标。血脂代谢指标分别为总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high lipoprotein,HDL)和低密度脂蛋白(low density lipoprotein,LDL)共计4项指标。依据GGT浓度的四分位数进行分组,对血脂四项指标水平进行组间的两两比较;分别分析GGT浓度与血脂4项指标的相关性;比较GGT在不同血脂异常分组间的水平差异;应用二元Logistic回归多因素分析筛选出影响GGT升高的危险因素。结果随着GGT浓度的升高,TC、TG和LDL水平及异常率明显上升,HDL水平明显降低且异常率增加,差异均具有统计学意义(P<0.05);Spearman相关性分析显示,GGT与TC、TG、LDL浓度水平均呈正相关(r_(s)=0.200、0.395、0.186,P<0.05),而与HDL呈负相关(r_(s)=-0.144,P<0.05);二元Logistic回归多因素分析显示,以中位数或参考值为界定,TG均是影响GGT浓度升高的独立危险因素,OR值分别为2.360(95%CI:2.068~2.695)和1.635(95%CI:1.481~1.805)。结论血脂代谢紊乱会导致GGT的异常升高,且升高幅度与血脂代谢异常程度密切相关。伴随有血脂异常的GGT升高可能有助于脂质代谢紊乱相关性疾病的诊断和治疗。

血清MAO、5’-NT、GGT检测在诊断原发性肝癌中的价值

目的探讨血清单胺氧化酶(MAO)、5′-核苷酸酶(5′-NT)、γ-谷氨酰基转移酶(GGT)检测在诊断原发性肝癌中的价值。方法选择43例原发性肝癌患者,52例良性肝病患者及35例健康体检者,比较各组血清MAO、5′-HT、GGT水平,并分析血清MAO、5′-HT、GGT水平在检测原发性肝癌中的价值。结果原发性肝癌组血清MAO、5′-HT、GGT水平高于良性肝病组,良性肝病组血清MAO、5′-HT及GGT水平高于健康对照组,差异有统计学意义(P<0.05)。血清MAO曲线下面积为0.718、敏感度和特异度分别为0.571和0.418;5′-NT曲线下面积为0.717、敏感度和特异度分别为0.558和0.476;GGT曲线下面积为0.714、敏感度和特异度分别为0.738和0.334;联合检测曲线下面积为0.884、敏感度和特异度分别为0.401和0.881,联合检测曲线下面积大于单个指标检测。结论血清MAO、5′-NT及GGT是反映肝功能损伤程度的敏感指标,联合检测可为原发性肝癌的诊断提供可靠依据。

血浆GGT水平与PCI术后支架内再狭窄的相关性研究

目的:观察PCI术后血浆GGT水平与支架内再狭窄的相关性。方法:选择70例支架植入术后8个月复查冠脉造影示无支架内再狭窄患者为对照组(A组),60例支架内再狭窄患者为再狭窄组(B组)(狭窄程度≥50%),采用标准方法测定其血浆GGT水平及相关生化指标,并对血浆GGT与再狭窄进行偏相关分析及多元逐步回归分析。结果:①血浆GGTB组明显高于A组(P<0.05);多元线性回归分析:血浆GGT与CRP水平的升高及ALP水平的降低能独立预测PCI术后支架内再狭窄(P<0.05)。结论:血浆GGT水平对预测支架内再狭窄有一定意义。