辅酶磷酸吡哆醛的存在对三种生化检测系统测定丙氨酸氨基转移酶活性的影响及其可比性研究

目的 探讨不同生化检测系统间测定丙氨酸氨基转移酶(ALT)活性结果的差异及其可比性.方法 使用ALT试剂中含有磷酸吡哆醛的DADE Dimension RXL检测系统、强生Vitros-350检测系统以及ALT试剂中未含有磷酸吡哆醛HITACHI7170检测系统同时测试164例患者和152例健康人群ALT活性并作比较,...     

本刊可以直接用的缩写词

血压（BP）血红蛋白（Hb）白细胞（WBC）红细胞（RBC）血小板（PLT）动脉血氧分压（PaO2）动脉血二氧化碳分压（PaCO2）丙氨酸氨基转移酶（ALT）天冬氨酸氨基转移酶（AST）     

丙氨酸氨基转移酶随年龄及性别变化趋势分析

目的:了解血清丙氨酸氨基转移酶(ALT)在正常人群不同性别及年龄段的生理性变化.方法:随机选择2007～2008年进行健康体检的健康成人及儿童,对各年龄段不同性别间做t检验,不同性别各年龄段结果进行方差分析中均数的两两比较,并对不同性别结果做单一线图.结果:①除儿童组外,其余各组包括成人合计不同性别间差异均存在显著性;②男性儿童组与成年组之间差异均存在显著性,男性成人组之间差异均无显著性(F=1.910,P=0.055),女性45岁以前组段与45岁以后组段差异多存在显著性;③男性20岁后基本保持稳定水平,女性45岁以前水平较均一,45岁以后呈现明显线性上升趋势.结论:正常人血清UA水平在不同性别、年龄段具有不同生理变化.     

慢性乙型肝炎患者外周血TH17、中性粒细胞、单核细胞的检测和意义

目的:探讨辅助性T细胞17(Th17)在慢性乙型肝炎(CHB)发生、发展中的作用及其与中性粒细胞,单核细胞的关系.方法:采用流式细胞仪检测55例CHB患者(CHB组)和33例查体健康(对照组)外周血Th17细胞比例;采用全自动生化分析仪测定血清丙氨酸氨基转移酶(ALT)水平;分析Th17细胞比例与血清ALT水平的相关性;采用ABI7500核酸定量检测仪测定乙肝病毒脱氧核糖核酸(HBV-DNA);采用SYSMEX全自动血液分析仪XE-500对外周血中的中性粒细胞、单核细胞进行绝对计数检测.结果:CHB组外周血Th17细胞比例、单核细胞绝对计数明显高于对照组(P＜0.01),而中性粒细胞绝对计数却低于健康组.Th17细胞比例与血清ALT水平、中性粒细胞、单核细胞绝对计数呈正相关,单核细胞绝对计数和血清ALT正相关.结论:Th17细胞诱导中性粒细胞的定向分化、迁移、趋化、以及抗微生物肽的释放,促进炎症反.激活的单核细胞促进TH17细胞分化增殖,在炎症条件下TH17细胞分泌的IL-17能有效地促进单核细胞的活化.三种细胞在慢乙肝感染免疫中紧密联系,并且与CHB肝脏损伤程度有关.     

原发性醛固酮增多症伴血清酶学增高一例

原发性醛固酮增多症是由于肾上腺皮质分泌过多的醛固酮而导致的综合征,1955年由Conn等首先报道[1].最常见的病因是醛固酮瘤,约占80%.醛固酮瘤多为单侧,直径为1~2 cm,超过2 cm以上者称为大腺瘤,颇为罕见.现报道一例4 cm醛固酮瘤伴有严重血清酶学改变的原发性醛固酮增多症病例.     

阻塞性睡眠呼吸暂停综合征对肝脏酶谱影响的配对研究

目的:评价阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)对肝脏酶学的影响。方法:选择30例按照体重指数配对的不同程度OSAS男性患者,进行睡眠呼吸暂停监测,并于清晨空腹抽血测定空腹血糖,空腹胰岛素水平,血清丙氨酸氨基转移酶、天门冬氨酸氨基转氨酶及乳酸脱氢酶水平。结果:按照体重指数配对的AHI<15/h与AHI>15/h的两组患者体重指数、年龄、腰臀比、颈围均无统计学差异。两组患者AHI水平有统计学差异(6.67±5.16/h vs 31.69±22.91/h,p=0.001);夜间最低血氧饱和度有统计学差异(88.07±6.69%vs 79.47±11.31%,p=-0.019)。AHI>15/h组患者胰岛素抵抗指数较AHI<15/h组患者升高并有统计学差异(1.47±0.58 vs 0.94±0.49,p=0.001)。AHI>15/h组患者空腹血清丙氨酸氨基转移酶水平较AHI<15/h组患者升高并有统计学差异(33.82±33.37 IU/L vs 20.06±13.64IU/L,p=0.040);乳酸脱氢酶水平升高并有统计学差异(165.83±37.50IU/Lvs144.93±21.28IU/L,p=0.047)。结论:随着OSAS严重程度增加,胰岛素抵抗程度增加,血清丙氨酸氨基转移酶及乳酸脱氢酶升高;提示OSAS可能通过间断缺氧途径及胰岛素抵抗途径导致肝功能损伤,引起非酒精性肝病。     

丙氨酸转氨酶偏高患者的健康教育

据《中华人民共和国食品安全法》第三十四条第二款,餐饮人员、食品经营人员每年应当进行健康检查,取得健康证明后方可参加工作,《中华人民共和国食品安全法实施条例》第四章第二十三条食品生产经营者应当依照食品安全法第三十四条的规定建立并执行从业人员健康检查制度和健康档案制度。     

病毒学因素对ALT持续正常的e抗原阴性慢性乙型肝炎病毒感染者肝脏组织学改变的影响

Objective To investigate the correlation between viral factors and liver histological changes of HBeAg-negative chronic hepatitis B patients with persistently normal serum ALT levels (PNAL). Methods HBV DNA level, HBV genotype, basal core promoter (BCP) and precore mutation were exam- ined in 52 HBeAg-negative chronic hepatitis B patients with PNAL (defined as normal ALT measured on at least 3 occasions in the intervals of about two months over a period of 12 months or more prior to the biopsy). Viral factors influencing histological changes of HBeAg-negative chronic hepatitis B patients with per-Results Subjects with both BCP and precore mutations had significantly higher HBV DNA levels than those without mutations [(4.9±1.4) vs (4.1±1.1) log10copies/ml, t = 2.308, P < 0.05]. A higher proportion of patients with histological activity index (HA1)≥ 4 was found in patients with both mutations (32.1% vs 16.7%) than in patients without mutation, however, the proportion of patients with histological activity index (HAl)≥ 3 in patients with mutations was not significantly different from that in patients without mutations (14.3% vs. 12.5%, χ2 = 0.000, P > 0.05). In patients without precore or BCP mutations, there was a strong positive correlation between viral load and liver inflammation as well as fibrosis (precore: r = 0.626, 0.592, P < 0.01; BCP: r = 0.730, 0.641, P < 0.01). In patients without both mutations, HBV DNA has shown a high accuracy for predecting fibrosis (F≥3) (AUC = 0.905, 95% CI: 0.771±1.039, P < 0.05) with the cutoff value of 4.5 log10copies/ml (sensitivity = 1.000, specificity = 0.778, PPV = 42.9%, NPV = 100.0%). Results of both genotypes and mutations were successfully obtained in 40 samples with HBV DNA≥ 104 copies/ml. The higher viral load was observed in the patients with genotype B than genotype C (5.1 vs 4.3 Iog,0copies/ml, t = 2.059, P < 0.05), but no difference was seen of liver pathologic changes between these two genotypes. Conclusions Virus harboring both BCP and precore mutants has the higher replication level than wild type virus. 32.1% and 14.3% of the patients with both mutations have moderate or severe inflammation and fibrosis. There was a strong positive correlation between viral load and liver histological changes in patients without precore or BCP mutations, and viral load shows a high accuracy for predecting sig-nificant fibrosis (F ≥ 3).     

肝移植成功救治超高血清肌酐避免肝肾联合移植1例

患者,男性,46岁.于2006年4月初无明显诱因出现全身乏力,上腹发胀,胃纳显著减少,恶心.随后出现深黄色尿,进行性皮肤、巩膜黄染.