血浆谷氨酸脱氢酶活性测定在肝胆疾病中的临床应用评价

目的:探讨血浆谷氨酸脱氢酶(glutamate dehydrogenase,GLDH)活性测定在肝脏疾病中的临床意义。方法:采用速率法检测229例肝功能异常者(急性肝损伤25例;慢性乙型肝炎60例;肝硬化47例;肝衰竭31例;胆道梗阻性疾病29例;肝癌37例)及120例健康体检者(作为对照组)的血浆GLDH活性,并与AST、ALT、ALT、GGT等常用肝胆疾病指标进行比较分析。结果:本室采用速率法测定GLDH活性的参考区间为4.4~13.3 U/L。胆道梗阻性疾病和肝癌患者血浆GLDH较对照组明显升高(P<0.05),胆道梗阻性疾病患者的GLDH/AST比值也明显高于对照组(P<0.05)。血浆GLDH浓度与AST浓度呈显著的正相关(r=0.230,P<0.001)。血浆GLDH浓度与肝损伤程度相关,随病情好转而降低。结论:胆道梗阻性疾病和肝癌患者血浆GLDH升高最为明显,GLDH可作为判断肝细胞损伤程度和疗效观察的指标。

The clinical significance of plasma GLDH activity in patients with liver disease

Objective:To investigate the clinical significance of glutamate dehydrogenase (GLDH)in patients with liver dis-ease.Methods:A total of 229 patients with liver disease (25 patients with acute hepatitis,60 CHB patients,47 patients with liver cir-rhosis,31 patients with liver failure,29 patients with biliary obstruction,37 patients with liver carcinoma)and 120 healthy subjects were enrolled.The liver enzymes of GLDH,AST,ALT,ALT and GGT were determined.Results:The activity of GLDH in liver diseases,espe-cially in patients with biliary obstruction and liver carcinoma,were significantly higher than that in healthy controls (P <0.05).The ra-tio of GLDH to AST in patients with biliary obstruction was significantly higher than that in healthy controls (P <0.05).The activities of GLDH closely related to the severity of liver damage and correlated with AST (r =0.230,P <0.001 ).Conclusion:The activity of GLDH was significantly increased in patients with biliary obstruction and liver carcinoma,and may be a biochemical marker for diagno-sing and evaluating the liver injury.