Prognostic utility of gamma-glutamyl transpeptidase to platelet ratio in patients with solitary hepatitis B virus-related hepatocellular carcinoma after hepatectomy

BACKGROUND The prognostic impact of preoperative gamma-glutamyl transpeptidase to platelet ratio(GPR)levels in patients with solitary hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC)following radical resection has not been established.AIM To examine the clinical utility of GPR for prognosis prediction in solitary HBVrelated HCC patients.METHODS A total of 1167 solitary HBV-related HCC patients were retrospectively analyzed.GPR levels were compared with 908 non-HCC individuals.Overall survival(OS)and recurrence-free survival(RFS)were evaluated,and cox proportional hazard model analyses were performed to identify independent risk factors.Differences in characteristics were adjusted by propensity score matching(PSM).Subgroup and stratified survival analyses for HCC risks were performed,and a linear trend of the hazard ratio(HR)according to GPR levels was constructed.RESULTS GPR levels of patients with solitary HBV-related HCC were higher than those with hepatic hemangiomas,chronic hepatitis B and healthy control(adjusted P<0.05).Variable bias was diminished after the PSM balance test.The low GPR group had improved OS(P<0.001)and RFS(P<0.001)in the PSM analysis and when combined with other variables.Multivariate cox analyses suggested that low GPR levels were associated with a better OS(HR=0.5,95%CI:0.36-0.7,P<0.001)and RFS(HR=0.57,95%CI:0.44-0.73,P<0.001).This same trend was confirmed in subgroup analyses.Prognostic nomograms were constructed and the calibration curves showed that GPR had good survival prediction.Moreover,stratified survival analyses found that GPR>0.6 was associated with a worse OS and higher recurrence rate(P for trend<0.001).CONCLUSION Preoperative GPR can serve as a noninvasive indicator to predict the prognosis of patients with solitary HBVrelated HCC.

Helicobacter pylori gamma-glutamyl transpeptidase and its pathogenic role

Helicobacter pylori(H.pylori)gamma-glutamyl transpeptidase(GGT)is a bacterial virulence factor that converts glutamine into glutamate and ammonia,and converts glutathione into glutamate and cysteinylglycine.H.pylori GGT causes glutamine and glutathione consumption in the host cells,ammonia production and reactive oxygen species generation.These products induce cell-cycle arrest,apoptosis,and necrosis in gastric epithelial cells.H.pylori GGT may also inhibit apoptosis and induce gastric epithelial cell proliferation through the induction of cyclooxygenase-2,epidermal growth factor-related peptides,inducible nitric oxide synthase and interleukin-8.H.pylori GGT induces immune tolerance through the inhibition of T cell-mediated immunity and dendritic cell differentiation.The effect of GGT on H.pylori colonization and gastric persistence are also discussed.

Helicobacter pylori γ-glutamyl transpeptidase:A formidable virulence factor

Helicobacter pylori(H.pylori)produce an enzyme known asγ-glutamyl transpeptidase(HpGGT)that is highly conserved and common to all strains.HpGGT has been gaining increasing attention as an important virulence factor of the bacterium,having been demonstrated to be an important colonization factor in several animal models and has also recently been strongly associated with the development of peptic ulcer disease.From the results of various independent researcher groups,it is clear that HpGGT acts through several pathways to damage gastric epithelial cells including the induction of apoptosis and cell cycle arrest,production of reactive oxygen species leading to DNA damage,promotion of inflammation by increasing cyclooxygenase-2 and interleukin-8 expression,and upregulation of heparin-binding epidermal growth factor-like growth factor resulting in cell survival and proliferation.In addition,the potential role of HpGGT in promoting gastric carcinogenesis will also be discussed in this review.Apart from affecting the gastric epithelium,HpGGT also has immunomodulatory actions on host immune cells where it displays an antiproliferative effect on T cells by inducing cell cycle arrest and also works with other H.pylori virulence factors to skew dendritic cells towards a tolerogenic phenotype,possibly contributing to the persistence of the pathogen in the gastric mucosa.

Gamma-glutamyl Transpeptidase to Platelet Ratio Predicts Liver Injury in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients With Normal Alanine Aminotransferase

Background and Aims:Chronic hepatitis B virus(HBV)infection is a serious health problem worldwide.Evaluating liver injury in patients with hepatitis B e antigen(HBeAg)-negative chronic hepatitis B(CHB)with detectable HBV DNA and normal alanine aminotransferase(ALT)is crucial to guide their clinical management.We aimed to investigate the stages of liver inflammation and fibrosis as well as the predictive accuracy of gamma-glutamyl transpepti-dase-to-platelet ratio(GPR)in these patients.Methods:A total of 184 treatment-naïve HBeAg-negative CHB pa-tients with detectable HBV DNA and normal ALT were enrolled.The Scheuer scoring system was used to classify liver inflammation and fibrosis.Results:The distribution of patients with different liver inflammation grades were as follows:G0,0(0%);G1,97(52.7%);G2,68(37.0%);G3,12(6.5%);and G4,7(3.8%).The distribution of patients with different liver fibrosis stages were as follows:S0,22(12.0%);S1,72(39.1%);S2,42(22.8%);S3,19(10.3%);and S4,29(15.8%).The areas under the re-ceiver operating characteristic(AUROC)curves of GPR in predicting significant inflammation,severe inflammation,and advanced inflammation were 0.723,0.895,and 0.952,respectively.The accuracy of GPR was significantly superior to that of ALT in predicting liver inflammation.The AUROCs of GPR in predicting significant fibrosis,severe fibrosis,and cirrhosis were 0.691,0.780,and 0.803,respectively.The predictive accuracy of GPR was significantly higher than that of aminotransferase-to-platelet ratio index(APRI)and fibrosis index based on four factors(FIB-4)in identifying advanced fibrosis and cirrhosis,and it was superior to FIB-4 but comparable to APRI in identifying significant fibrosis.Conclusions:Nearly half of the HBeAg-negative CHB patients with detectable HBV DNA and normal ALT levels had significant liver inflammation or fibrosis.GPR can serve as an accurate predictor of liver inflammation and fibrosis in these patients.

The clinical implication of gamma-glutamyl transpeptidase in COVID-19

Background and aim:Coronavirus disease 2019(COVID-19)is a life-threatening disease that predomi-nantly causes respiratory failure.The impact of COVID-19 on other organs remains elusive.Herein,we aimed to investigate the effects of COVID-19 on the hepatobiliary system.Methods:In the current study,we obtained the clinical records and laboratory results from 66 laboratory-confirmed patients with COVID-19 at the Wuhan Tongji Hospital between 10 February 2020 and 28 February 2020.The detailed clinical features and laboratory findings were collected for analysis.Bioinformatics analysis was conducted to evaluate the correlation between gamma-glutamyl transferase(GGT)and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entry receptor angiotensin-converting enzyme 2(ACE2).Results:In this cohort,30(51.7%)patients had abnormal liver function on admission,which was asso-ciated with disease severity and enriched in the male and diabetic patients.The elevated levels of direct bilirubin(P¼0.029)and GGT(P¼0.004)were common in patients with severe pneumonia when compared with those with mild pneumonia.In addition,elevated levels of GGT(P¼0.003)and aspartate aminotransferase(AST)(P¼0.007)were positively associated with longer hospital stay.The expression of ACE2 was closely associated with GGT in various human tissues because they shared the common transcriptional regulator hepatic nuclear factor-1 b(HNF1B).Conclusions:Increased GGT levels were common in severe cases and elevated GGT levels were positively associated with prolonged hospital stay and disease severity.Due to the consistent expression with ACE2,GGT is a potent biomarker indicating the susceptibility of SARS-CoV-2 infection.

GGT/PLT比值对广东地区慢性乙型肝炎患者肝纤维化分期的预测价值

目的探讨GGT/PLT比值(GPR)预测广东地区慢性乙型肝炎患者肝纤维化分期的价值。方法收集2010年1月-2016年12月于广州市第八人民医院行肝活组织检查诊断为慢性乙型肝炎的患者501例,其中HBe Ag阳性335例,HBe Ag阴性166例。分析比较GPR、GGT、AST/PLT指数(APRI)及FIB-4对肝纤维化分期(F1~F4)的预测价值。Spearman相关系数分析诊断模型指标与肝纤维化分期的相关性,采用受试者工作特征(ROC)曲线下面积评估各模型对肝纤维化分期的预测价值。结果肝活组织病理检查作为金标准,F1~F4期患者分别为141、183、139、38例。Spearman相关分析显示,HBe Ag阳性和HBe Ag阴性患者GGT、GPR、APRI和FIB-4均与肝纤维化分期呈正相关(r值分别为0.459、0.526、0.320、0.470、0.272、0.366、0.288、0.388,P值均<0.001),PLT与肝纤维化分期呈负相关(r值分别为-0.333、-0.349,P值均<0.001)。ROC曲线分析结果显示,GPR对于HBe Ag阳性慢性乙型肝炎患者明显肝纤维化(≥F2)、进展期肝纤维化(≥F3)及早期肝硬化(F4)的预测价值优于GGT和APRI(P值均<0.05),而与FIB-4的预测价值相近(P值均>0.05);GPR对于HBe Ag阴性慢性乙型肝炎患者明显肝纤维化(≥F2)的预测价值优于GGT和APRI(P值均<0.05),对进展期肝纤维化(≥F3)的预测价值优于GGT(P<0.05),而对早期肝硬化(F4)的预测价值与GGT、APRI、FIB-4相近(P值均>0.05)。结论 GPR可以作为广东地区慢性乙型肝炎患者肝纤维化分期的无创生化预测指标,尤其是对于HBe Ag阳性患者,其预测价值与FIB-4相近,亦不亚于APRI。

原发性肝癌预后的相关因素分析

将 163例原发性肝癌患者的性别、年龄、乙肝表面抗原等 14项变量设定为相关因素 ,以相关因素为自变量 ,以生存时间为因变量 ,采取Cox逐步回归分析方法。结果肝外转移、胆红素及γ -谷氨酰转肽酶等 3项因素与肝癌患者的生存期明显相关 ,而其他 11项因素尤其是通常认为与肝癌患者的生存期有较为密切的相关的甲胎蛋白、谷丙转氨酶、白蛋白、球蛋白、肝硬化、腹水及乙肝表面抗原等因素在经过逐步回归后 ,差异无显著意义 ;腹水。

甲胎蛋白和其他血生化指标构建潜在的胆道闭锁患儿早期诊断模型

背景:胆道闭锁主要依赖于术中诊断,操作复杂且对待诊患儿的伤害较大,不适合作为早期诊断的方法。因此,寻找简单有效的血液生化诊断指标将改善早期诊断效率。目的:检测胆道闭锁患儿血浆甲胎蛋白水平,探索甲胎蛋白和血液生化指标在胆道闭锁临床诊断中的应用价值。方法:收集48例胆道闭锁患儿、20例肝炎患儿与9名健康婴儿血液样本,采用酶联免疫吸附试验测定患儿血浆中甲胎蛋白质量浓度,分析甲胎蛋白与血生化指标的相关性,建立潜在的诊断模型。试验通过新华医院伦理委员会的批准(批准号:XHEC-D-2013-026)。结果与结论:(1)胆道闭锁组和肝炎组甲胎蛋白质量浓度显著高于健康组(P <0.001),胆道闭锁组和肝炎组甲胎蛋白质量浓度比较差异无显著性意义(P>0.05);(2)48例胆道闭锁患儿中,不同肝纤维分级患儿间的甲胎蛋白质量浓度比较差异无显著性意义(P> 0.05);(3)血液生化指标显示,胆道闭锁组和肝炎组均有严重的肝损伤,两组前白蛋白、γ-谷氨酰胺转肽酶水平比较差异有显著性意义(P<0.05,P<0.001);(4)甲胎蛋白和γ-谷氨酰胺转肽酶水平呈现负相关(r=-0.516,P <0.01);(5)结合甲胎蛋白、前白蛋白、γ-谷氨酰胺转肽酶及患儿年龄和性别建立了一个潜在的诊断模型,敏感性为81.82%,特异性为91.67%,模型的曲线下面积AUC达到0.939;(6)结果说明,胆道闭锁患儿血浆甲胎蛋白水平明显升高,通过甲胎蛋白等生化指标构建的诊断模型对胆道闭锁临床诊断有一定的参考价值。

Nonalcoholic steatohepatitis in nonalcoholic fatty liver disease patients of Bangladesh

AIM: To explore the prevalence and risk factors for nonalcoholic steatohepatitis (NASH) in nonalcoholic fatty liver disease (NAFLD) patients. METHODS: We have included 493 patients with sonographic evidence of a fatty change, and 177 of these individuals were evaluated and confirmed after liver biopsy. The exclusion criteria consisted of significant alcohol abuse (【 20 g daily), evidence of hepatitis B and C, evidence of drug-induced fatty liver disease and other specific liver diseases such as hemochromatosis, Wilson’s disease or autoimmune liver disease. The patients were assessed for metabolic syndrome, and biochemical, anthropometric and histopathological evaluations were carried out. The degree of disease activity in the NAFLD patients was evaluated using the NAFLD Activity Score. The data were analyzed by SPSS, version 16.0. RESULTS: Females predominated among the study participants (250, 57.0%), and the mean age was 40.8 ± 10.2 years. The numbers of overweight, obeseⅠ and obese Ⅱ patients were 58 (13.2%), 237 (53.9%) and 93 (21.2%), respectively. However, there were 422 (96.2%) centrally obese patients. NASH was absent in 10 (5.6%) cases, borderline in 92 (52.6%) cases and present in 75 (42.4%) cases. The presence of diabetes could significantly (P = 0.001) differentiate NASH from simple steatosis. The following parameters did not influence the development of NASH: age, sex, basal metabolic index, waist circumference, serum high-density lipoprotein, triglyceride, insulin resistance index, hypertension and metabolic syndrome. The serum gammaglutamyl transpeptidase (GGT) level was significantly higher (P = 0.05, 51.7 ± 32.8 and 40.4 ± 22.6 U/L) in the NASH patients, with a sensitivity of 45% and a specificity of only 68%. The serum alanine aminotransferase and aspartate aminotransferase levels were not able to predict NASH. CONCLUSION: Females were the predominant sufferers of NAFLD in Bangladesh. The prevalence of NASH was high. Diabetes was found to be the main culprit in developing NASH. GGT was the only biochemical marker of NASH. We recommend liver biopsy in NAFLD patients who have diabetes and elevated GGT.

Relationship between alcohol consumption and clinical manifestation of patients with fatty liver:a single-center study

BACKGROUND:Fatty liver is a common chronic liver disease worldwide.It is associated with an increasing morbidity in China in recent years.The aim of this study was to analyze the effect of drinking alcohol on the hemoglobin and biochemical values of patients with fatty liver.METHODS:We investigated the clinical and laboratory data of 669 patients with fatty liver.Of the 669 patients,166 consumed alcohol more than 60 g per week for at least 2 years,and 503 did not have a history of long-term alcohol consumption.We further analyzed the relationship between alcohol consumption and clinical characteristics of these patients.RESULTS:The values of aspartate transaminase (AST),gammaglutamyl transpeptidase (GGT),and hemoglobin in the long-term consumption group were significantly higher than those in the non long-term consumption group (P<0.05).In the patients without long-term alcohol consumption,the values of GGT and hemoglobin in patients with light alcohol consumption were significantly higher than those in non alcohol consumers (P<0.05).CONCLUSION:Alcohol consumption is associated with significantly increased values of AST,GGT,and hemoglobin in patients with fatty liver,suggesting their potential roles in hepatic steatosis.

CHI3L1和GPR对肝纤维化患者的诊断效能比较

目的比较壳多糖酶3样蛋白1(chitinase-3-like protein 1,CHI3L1)、γ-谷氨酰转肽酶和血小板比值指数(γ-glutamyl transpeptidase platelet ratio index,GPR)对肝纤维化患者的诊断效能。方法回顾性选择2019年1月—2020年6月本院收治的拟诊为肝纤维化患者524例,所有患者均经肝穿刺活检确诊412例,所有患者均检测CHI3L1和GPR水平,并与肝穿刺活检结果比较。结果不同分期肝纤维化CHI3L1和GPR水平比较,随着肝纤维化严重程度增加而增加(P<0.05)。CHI3L1检查肝纤维化患者与活体穿刺结果准确率为96.84%,Kappa=0.76,提示CHI3L1检查与活体穿刺结果有较高的一致性;GPR检查与活体穿刺准确率为52.91%,Kappa=0.48,提示GPR检查肝纤维化患者与肝活体穿刺结果的一致性一般。CHI3L1诊断肝纤维化的AUC为0.939,灵敏度为89.83%,特异度为77.75%;GPR诊断肝纤维化的AUC为0.829,灵敏度为79.66%,特异度为79.77%。CHI3L1检验肝纤维化的AUC高于GPR检验肝纤维化的AUC。结论CHI3L1较GPR更利于作为肝纤维化的诊断及不同分期肝纤维化的标记物,因其不同分期表达水平不同,其也可作为动态观察肝纤维化进展的检测标记物。

Silymarin in non alcoholic fatty liver disease

AIM: This study was undertaken to evaluate the hepatic effects of silybum marianum on non alcoholic fatty liver disease (NAFLD). METHODS: In 72 patients affected by NAFLD, main metabolic, hepatic and anti-inflammatory parameters were assayed after 3 mo of a restricted diet and before silymarin treatment (twice a day orally). The brightness of liver echography texture (hepatorenal ratio brightness) was also defined at same time. These evaluations were repeated after 6 mo of treatment. RESULTS: Serum levels of some metabolic and anti-inflammatory data nonsignificantly lowered after 6 mo of silymarin. On the contrary, Steato test, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase were significantly (P < 0.001) reduced. Instead, the AST/ALT ratio unchanged. Finally, the hepatorenal brightness ratio, as an index of hepatic steatosis, significantly (P < 0.05) dropped. CONCLUSION: The obtained results indicate that silymarin appears to be effective to reduce the biochemical, inflammatory and ultrasonic indices of hepatic steatosis. Some parameters indicative of early stage of atherosclerosis were also lowered.

肾结石ESWL前后尿γ-GT含量、红细胞计数和形态的表现及其意义

通过对12例肾结石患者体外冲击波碎石术（ESWL）前后尿γ－谷氨酰胺转肽酶（γ－GT）含量、红细胞计数和形态的检测，发现ESWL后第4d尿γ－GT含量明显增高（P＜0．01），尿多形型红细胞比例亦增高，而尿红细胞计数在ESWL后即到明显增高（P＜0．01）。表明尿γ－GT含量、红细胞计数和形态可作为评估肾脏受损的指标。结合先期同条件下研究血过氧化脂质（LPO）含量异常的结果，认为尿γ－GT含量增高、红细胞形态异常与氧自由基因素有关。

225名处级干部部分生化体检指标检测结果分析

目的探讨邯郸矿业集团225名矿处级体检干部中,脂肪肝组与非脂肪肝组血液部分生化检测指标间的关系,提醒其关注自身健康。方法对邯郸矿业集团总医院2010年7～11月体检中心接诊的225名矿处级干部的三酰甘油(TG)、空腹血糖(FPG)、γ-谷氨酰转移酶(γ-GGT)、血尿酸(UA)检测指标进行回顾性调查分析,并按其是否患有脂肪肝将结果分为两组,并进行统计学分析研究。结果脂肪肝组与非脂肪肝组的TG、FPG、γ-GGT、UA异常检出率分别是59.84%、41.73%、74.02%、15.75%和24.49%、18.37%、18.37%、1.02%,脂肪肝组各项指标异常检出率均明显高于非脂肪肝组,两者差异有统计学意义(P<0.01)。并且两组TG、FPG、γ-GGT、UA的平均浓度,脂肪肝组明显高于非脂肪肝组,两者差异具有统计学意义(P<0.01)。结论高血脂、高血糖是诱发脂肪肝的重要因素,脂肪肝患者是发生肝病、痛风和心脑血管病的高发人群,领导干部健康问题不容忽视,应加强锻炼,合理膳食,积极治疗,提高身体健康水平。

血液标本放置时间的长短对生化检验结果及γ-谷氨酰转肽酶水平的影响

目的探析血液标本放置时间的长短对生化检验结果及γ-谷氨酰转肽酶水平的影响。方法方便选取2019年3—6月在该院进行血液检查的120例患者进行分组研究,根据血液标本放置时间长短分为甲组(n=30,1 h)、乙组(n=30,4 h)、丙组(n=30,8 h)、丁组(n=30,24 h),分别检测葡萄糖(GLU)、三酰甘油(TG)、总胆固醇(TC)、总胆红素(TBIL)、直接胆红素(DBIL)、尿素氮(BUN)、清蛋白(ALB)、总蛋白(TP)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、钠离子(Na+)、钾离子(K+)、钙离子(Ca2+)、氯离子(Cl-)、磷离子(P-)。结果甲组GLU、TC、TBIL、BUN、ALB、TP、AST、ALT、GGT、ALP、Na+、K+、Ca2+、Cl-、P-水平分别为(5.22±1.23)mmol/L、(4.45±0.67)g/L、(16.34±1.75)μmol/L、(4.93±0.52)mmol/L、(51.15±3.98)g/L、(72.42±4.75)g/L、(22.51±5.17)U/L、(28.76±5.61)U/L、(30.59±5.14)U/L、(59.76±4.27)U/L、(137.08±1.63)mmol/L、(4.08±0.32)mmol/L、(2.24±0.37)mmol/L、(99.94±1.54)mmol/L、(0.98±0.03)mmol/L,与甲组比较,乙组GLU[(4.81±1.15)mmol/L]水平显著降低(P<0.05);丙组GLU[(4.62±1.20)mmol/L]、TBIL[(15.41±1.64)μmol/L]、BUN[(4.46±0.56)mmol/L]水平显著降低,AST[(26.15±5.37)U/L]、K+[(4.54±0.41)mmol/L]水平显著升高,差异有统计学意义(P<0.05);丁组GLU[(4.30±1.14)mmol/L]、TBIL[(15.22±1.62)μmol/L]、BUN[(4.22±0.55)mmol/L]、ALT[(25.18±5.26)U/L]、GGT[(28.54±5.19)U/L]、Cl-[(96.05±1.37)mmol/L]、P-[(0.89±0.01)mmol/L]水平显著降低,TC[(4.87±0.53)g/L]、ALB[(52.75±3.89)g/L]、TP[(74.62±4.45)g/L]、AST[(31.73±5.61)U/L]、ALP[(65.13±4.42)U/L]、Na+[(139.98±1.39)mmol/L]、K+[(5.18±0.45)mmol/L]、Ca2+[(2.76±0.31)mmol/L]水平显著升高,差异有统计学意义(P<0.05)。结论血液标本放置时间越长,对生化检验结果的影响越明显,GGT水平下降幅度也越大,所以,应对血液标本进行及时检测,以此避免误差。

血液标本放置时间的长短对生化检验结果及γ-谷氨酰转肽酶水平的影响分析

目的:探析血液标本放置时间的长短对生化检验结果及γ-谷氨酰转肽酶(γ-GT)水平的影响。方法:选取门诊接受血液生化检验患者100例,所有患者采集血液标本后,均于放置1、4、8 h时检验8项常规生化指标。对比分析不同放置时间长短对生化检验结果及γ-GT水平的影响。结果:放置4 h时谷丙转氨酶(ALT)、血糖(GLU)等检验结果与放置1 h时对比差异有统计学意义(P<0.05);放置8 h时γ-GT、ALT、碱性磷酸酶(ALP)、钾离子(K^+)、胆固醇(CHOL)、总胆红素(TB)、GLU等检验结果与放置1 h时对比差异有统计学意义(P<0.05)。结论:血液标本放置时间过长会对生化检验指标γ-GT、ALT、ALP、K+、CHOL、TB、GLU等产生显著影响,因此必须对检验顺序予以合理安排,以提升血液生化检验结果的有效性、准确性以及可靠性。

Transient elevation of hepatic enzymes in volunteers after intake of alcohol

BACKGROUND: In the organs that mediate alcohol effects on the human body and its health, the liver plays a particular important role. This study was designed to detect the changes of hepatic enzymes after alcohol intake and evaluate the corresponding damage to the human body. METHODS: Fifteen volunteers were included according to the criteria. After the intake of 80g ethanol containing beverage, alcohol levels were detected and blood samples were collected at 0.5-to 3-hour interval to detect the levels of hepatic enzymes simultaneously. RESULTS: After the intake of 80g ethanol, various symptoms occurred in volunteers while the concentration of blood alcohol peaked at 1 hour and normalized within 24 hours. The ratio of alanine aminotransferase (ALT) to aspartate aminotransferase (AST) increased significantly when the venous alcoholic concentration increased from 0g/L to 1.2g/L and the levels of alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase(γ-GT) were elevated when the alcoholic concentration reached 0.4g/L. No significant changes were noticed in ALT, AST or cholinesterase (CHE). CONCLUSION: Acute alcohol intoxication may cause the changes of hepatic enzymes and prove the existence of reversible hepatic injury.

用血生化检查诊断肝硬化的价值分析

目的:研究用血生化检查诊断肝硬化的价值。方法:选取2016年10月至2018年5月中江县人民医院收治的50例肝硬化患者与同期在该医院进行体检的50例健康人作为研究对象。将其中50例肝硬化患者设为观察组(OBG组),将其中50例健康人设为对照组(REG组)。对两组研究对象均进行血生化检查,然后比较对其进行检查的结果,同时比较OBG组患者中轻度肝硬化患者与重度肝硬化患者的各项血生化指标。结果:OBG组患者血清γ-谷氨酰转肽酶、总胆红素、碱性磷酸酶、天冬氨酸氨基转移酶、直接胆红素与丙氨酸氨基转移酶的水平均高于REG组健康人,其血清白蛋白、胆碱酯酶与总蛋白的水平均低于REG组健康人,P<0.05。在OBG组患者中,重度肝硬化患者血清γ-谷氨酰转肽酶、总胆红素、碱性磷酸酶、天冬氨酸氨基转移酶、直接胆红素与丙氨酸氨基转移酶的水平均高于轻度肝硬化患者,其血清白蛋白、胆碱酯酶与总蛋白的水平均低于轻度肝硬化患者,P<0.05。结论:对肝硬化患者进行血生化检查对诊断其病情具有重要的参考价值,且有助于判断其病情的严重程度。

视神经脊髓炎与多发性硬化患者血清碱性磷酸酶、谷氨酸转移酶水平观察

目的 观察视神经脊髓炎（NMO）与多发性硬化（MS）患者血清碱性磷酸酶（ALP）、谷氨酰转移酶（GGn水平.方法 在中山大学附属第三医院脱髓鞘疾病数据库中调取自2007年1月至2010年3月收治的177例NMO、MS患者资料及85例同期健康体检者资料,分析其血清ALP、GGT水平,探讨其与年龄、病程、发作次数、EDSS评分的关系.结果 NMO组患者血清ALP、GGT水平较MS组及对照组增高,进一步观察发现NMO患者血清ALP水平在病灶活动期时亦高于MS患者,且男性NMO患者血清ALP水平、女性NMO患者血清GGT水平均高于MS组与对照组,差异有统计学意义（P〈0.05）.NMO患者血清GGT水平与其年龄、发病次数呈正相关（p〈0.05）.结论 ALP、GGT在NMO、MS患者血清中含量不同,在一定程度上有助于鉴别诊断这两种疾病.

益阴降糖1号方治疗气阴两虚、瘀血内阻型糖尿病肾病临床研究

目的:观察自拟益阴降糖1号方辨治气阴两虚、瘀血内阻型糖尿病肾病的临床疗效。方法:106例气阴两虚、瘀血内阻型糖尿病肾病患者按照随机数字表法分为对照组和观察组各53例。对照组患者给予厄贝沙坦片口服,观察组患者给予自拟益阴降糖1号方,15 d为1个疗程,两组均连续治疗4个疗程。比较两组患者临床疗效,检测治疗前后糖脂代谢、血液流变、肾功能指标,监测治疗前后患者血清γ-谷氨酰转肽酶(gamma glutamyl transpeptidase,GGT)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、缺氧诱导因子-1α(hypoxia-induced factor-1α,HIF-1α)水平。结果:观察组有效率为94.3%,对照组有效率为79.2%,两组比较,差异有统计学意义(χ2=5.267,P<0.05)。治疗后,观察组患者糖脂代谢、血液流变、肾功能指标与对照组比较,差异均有统计学意义(P<0.05)。治疗后,观察组患者GGT、VEGF、HIF-1α水平分别为(24.60±17.42)IU·L^(-1)、(126.45±23.74)ng·L^(-1)、(135.35±13.17)pg·L^(-1),对照组分别为(31.26±19.33)IU·L^(-1)、(182.34±25.15)ng·L^(-1)、(187.62±16.32)pg·L^(-1),两组比较,差异有统计学意义(P<0.05)。治疗后,观察组肾功能各指标均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组血液流变学各指标均低于对照组,差异有统计学意义(P<0.05)。结论:自拟益阴降糖1号方辨治气阴两虚、瘀血内阻型糖尿病肾病疗效满意,可显著降低患者血糖水平,调节脂质代谢,改善肾功能,其机制可能为调节血液流变学指标及GGT、VEGF、HIF-1α水平以改善肾脏微循环、调节内皮功能、减轻氧化应激损伤、降低炎性反应。