血清碱性磷酸酶红腰豆凝集素结合率测定在肝癌诊断中的意义

目的观察血清碱性磷酸酶L型红腰豆凝集素(L-PHA)结合率测定在肝癌诊断中的意义。方法采用凝集素亲和层析法测定50例正常人、103例原发性肝癌、22例肝硬化、36例慢性肝炎、18例急性肝炎和13例消化道肿瘤患者的血清碱性磷酸酶L-PHA结合率。结果原发性肝癌患者血清碱性磷酸酶L-PHA结合率(16.01±5.42)%明显高于正常对照组(7.50±2.53)%(P<0.01),且与肿瘤大小、AFP水平呈显著性正相关(P<0.01)。肝硬化、慢性肝炎和消化道肿瘤组轻度增高,而急性肝炎组未见显著性改变。结论血清碱性磷酸酶L-PHA结合率测定有助于原发性肝癌的实验诊断。     

不同孕期妇女血清碱性磷酸酶的变化及意义

目的 探讨妊娠期血清碱性磷酸酶(ALP)的变化及意义.方法 用ELIMAT-240生化分析仪对459例妊娠妇女(实验组)及108例育龄非孕健康妇女(对照组)血清ALP值进行监测.结果 早期妊娠时血清ALP值为(43.17±13.25)U/L,较对照组(64.21±19.84)U/L要低(P＜0.001);中期妊娠时血清ALP值为(62.24±19.57)U/L,与对照组相比差异无统计学意义(P＞0.05);晚期妊娠时血清ALP值为(124.20±63.28)U/L,与对照组相比显著增高(P＜0.001);妊娠高血压综合征患者血清ALP值为(253.61±42.74)U/L,较对照组及晚期妊娠组高(P＜0.001);过期妊娠患者血清ALP值为(40.28±8.43)U/L,比晚期妊娠组及对照组低(P＜0.001).结论 健康妊娠在早孕时血清ALP值轻度降低,中期妊娠时无显著变化,晚期妊娠及妊娠高血压综合征时血清ALP值显著升高,但过期妊娠时则有所下降.     

血清碱性磷酸酶水平检测对原发性高血压患者靶器官损伤的相关性研究

目的分析原发性高血压患者血清碱性磷酸酶(ALP)水平与患者靶器官损伤的相关性。方法回顾性分析该院心血管内科收治的186例原发性高血压患者(观察组)和同期在该院体检的35例体检健康者(健康对照组)的临床资料,依据头颅CT检查结果将患者分为并发腔隙性脑梗死组(n=63)和未并发腔隙性脑梗死组(n=123),根据肾功能生化结果分为并发肾功能损害组(n=52)和未并发肾功能损害组(n=134),检测各组血清ALP水平,比较各组临床资料,并分析ALP水平与原发性高血压患者靶器官损伤的相关性。结果并发腔隙性脑梗死组、并发肾功能损害组血清ALP分别高于未并发腔隙性脑梗死组、未并发肾功能损害组,且均高于健康对照组,差异有统计学意义(P0.05);ALP、年龄、饮酒史、血压是原发性高血压患者靶器官损伤的影响因素(P0.05),原发性高血压患者靶器官损伤与血压和ALP有显著相关性(r=0.305、0.321,P0.05)。结论原发性高血压靶器官损伤患者血清ALP水平明显升高,血清ALP水平与原发性高血压患者靶器官损伤存在明显的相关性,临床可定期监测原发性高血压患者血清ALP水平以延缓疾病进展。     

甲亢患者检测血清碱性磷酸酶的临床意义

血清碱性磷酸酶(ALP)活性的升高临床上常见于骨骼疾患和肝胆疾病,甲状腺机能亢进(简称甲亢)患者一般来说机体处于一种非正常的高骨质代谢状态,在临床上多见血清ALP升高.目前对其机制已有研究报道[1,2].作者对70例甲亢患者测定其空腹血清ALP、FT3、FT4,并选46例健康人作对照,旨在探讨甲亢患者检测ALP的临床意义.     

补肾方药对绝经后骨质疏松症患者骨密度及血钙、血清碱性磷酸酶的影响

目的观察补肾方药对绝经后骨质疏松症患者的类雌激素样作用,以及提高骨密度、促进骨形成的作用.方法选择2003-03/2004-10广东省海丰县中医医院骨科入院及门诊治疗的绝经后骨质疏松症患者70例,随机分为治疗组（n=33）及对照组（n=37）.治疗组口服中药健骨方制剂（由补骨脂、肉苁蓉、淫羊藿、菟丝子、熟地黄、白芍等组方）,对照组服用阿仑膦酸钠片,两组均连服3个月.于治疗前及治疗后3个月检查两组患者骨密度、雌二醇水平、血清碱性磷酸酶及血钙水平.结果治疗组治疗后血清碱性磷酸酶水平低于治疗前,雌二醇水平及骨密度治疗后高于治疗前,差异均有显著性（P＜0.05～0.01）.对照组雌二醇水平及骨密度治疗后高于治疗前,差异均有显著性（P＜0.05～0.01）.两组治疗后血清碱性磷酸酶、血钙、雌二醇水平及骨密度比较,差异均无显著性（P＞0.05）.结论补肾方药在提高绝经后骨质疏松患者性激素水平及骨密度的作用与阿仑膦酸钠片相当,健骨方具有类雌激素样作用及促进骨形成的作用.     

检测慢性肝病患者血清BMP2和BMP4的临床价值

目的研究慢性肝病患者血清中的骨形态发生蛋白2(BMP2)和骨形态发生蛋白4(BMP4)的表达,了解两者在诊断和鉴别诊断原发性肝癌(PHC)中的临床价值。方法按照病理学诊断或者临床资料诊断,对住院的60例患者进行分组,PHC组25例,肝硬化组17例,肝炎组18例。9例健康对照组采自同期健康体检者。分别检测各组患者及正常者血清甲胎蛋白(AFP)、BMP2和BMP4。结果①PHC组患者血清中的BMP2较健康对照组、肝炎组、肝硬化组低,差异都有统计学意义(P<0.05)。②PHC组患者血清BMP4较其余3组组低,差异都有统计学意义(P<0.01)。③BMP2诊断PHC的敏感性为92.00%,特异性为100%,准确率是97.10%;BMP4诊断PHC的敏感性为80.00%,特异性为100%,准确率为92.75%。结论 BMP2、BMP4对PHC的诊断和鉴别诊断具有一定的价值。     

碱性磷酸酶对大鼠自体原位肝移植后急性肺损伤的保护作用

目的:肝移植术后并发症不仅包括肝脏本身的损害,亦能导致肝外多个器官功能衰竭,其中肺脏是较易且较早受累的器官.文章通过建立大鼠自体原位肝移植模型,观察肝移植术后肺部急性损伤情况及碱性磷酸酶的干预作用.方法:①实验于2007-05/10在南方医科大学附属南方医院实验动物中心、消化内科实验室完成,动物实验方法符合动物伦理学要求.②选用SD大鼠24只,按随机数字表法分为对照组、自体原位肝移植组和碱性磷酸酶组,每组8只.后两组建立大鼠自体原位肝移植模型,对照组开腹后游离肝叶后即关腹,碱性磷酸酶组于肝脏恢复血供前5 min自舌静脉注入碱性磷酸酶.③手术结束后2 h检测肺组织髓过氧化物酶活性、丙二醛含量、肺组织表面活性蛋白A含量及肺组织干湿重比值,并行肝脏、肺脏病理检查.结果:大鼠24只全部进入结果分析.①自体原位肝移植组、碱性磷酸酶组肺组织中髓过氧化物酶活性、丙二醛含量均高于对照组(P﹤0.01),碱性磷酸酶组肺组织中髓过氧化物酶活性、丙二醛含量均低于自体原位肝移植组(P﹤0.01).②碱性磷酸酶组、自体原位肝移植组肺组织表面活性蛋白A含量较对照组低,而碱性磷酸酶组较自体原位肝移植组有所升高.③自体原位肝移植组、碱性磷酸酶组肺组织干湿重比值均低于对照组(P﹤0.01),碱性磷酸酶组肺组织干湿重比值高于自体原位肝移植组(P﹤0.05).④病理结果显示,肝移植后大鼠肝、肺组织受到明显损害,而碱性磷酸酶能减轻损伤程度.结论:肝移植术后肺部确实存在急性损伤,而碱性磷酸酶对其具有保护作用.     

High-molecular intestinal alkaline phosphatase in chronic liver diseases

The presence of high-molecular intestinal alkaline phosphatase (HIALP) different from bone ALP detected in the alpha(2)beta region was recently clarified. In this study we used a novel method in which HIALP was detected after conversion to ALP(5) by protease to investigate the clinical significance of the appearance of HIALP in patients with chronic liver disease. The subjects were 241 patients with chronic liver disease. When a decrease in ALP(3) in the alpha(2)beta region and an increase in ALP(5) in the beta region were noted, the patient was judged HIALP-positive. In the patients with chronic liver disease, the total ALP activity (T-ALP) increased with progression of the pathology in the order of chronic hepatitis (CH), liver cirrhosis (LC), and hepatocellular carcinoma (HCC). HIALP appeared in 22.4% and 49.3% of patients with CH and LC, respectively, but the positivity rate decreased to 30.4% in HCC. As autoimmune liver diseases, primary biliary cirrhosis (PBC) and autoimmune hepatitis (AIH) were investigated. T-ALP was lower in PBC+AIH than in LC and HCC, but the HIALP-positive rate was high (44.4%). The HIALP-positive rate was dependent on ABO blood groups, and was high in blood groups B and O. In conclusion, the HIALP-positive rate was particularly high in patients with chronic liver disease, and was related to the pathological progression, which suggests that the method is clinically useful.     

A comparison of canine normal hepatic alkaline phosphatase and variant alkaline phosphatase of serum and liver.

The isoenzyme of alkaline phosphatase from normal liver, the corticosteroid induced isoenzyme of alkaline phosphatase from serum and liver and a hepatocellular variant isoenzyme of alkaline phosphatase induced by lymphosarcoma have been partially purified and their the present modification incorporates Polybrene into buffer to eliminate this heparin interference. The proposed method shown excellent agreement with a reference procedure based on clottable protein, and excellent day-to-day precision (C.V.3.5%). The present method is easily adaptable to semi-automated measurements.     

血清肝纤维化指标在肝脏疾病中的变化

目的探讨血清肝纤维化指标对肝病病变程度及预后的意义。方法以竞争性放射免疫分析法检测了78例不同类型、不同程度慢性肝病患者血清透明质酸（HA）、Ⅲ型前胶原（PCⅢ）及Ⅳ型胶原（IVC）3项指标，并设立30例健康对照。结果各组肝病患者血清透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、IV型胶原（IVC）指标与健康对照组比较均有不同程度的升高，其中以中、重度慢性肝炎组和活动性肝硬化组升高最为明显，而IVC则以酒精性肝病组升高最为明显。结论血清肝纤维化3项指标联合检测在肝纤维化程度的判断中具有较高的临床价值，在连续动态观察肝病进展及病变程度方面是一组良好的指标，对肝病的预后具有一定的指导意义。     

Endothelial and bile canalicular alkaline phosphatase in human liver and serum.

The alkaline phosphatase in homogenates of human liver was separated into two components by the addition of Triton X-100 to an agarose gel electrophoretic system. One of these components migrated at a rate identical to that of the original one and similar to alpha2-macroglobulin. The other component migrated more slowly, at a rate that resembled that of beta1-transferrin. Human serum samples regularly contained an identical fast-migrating fraction, whereas an identical slowly migrating fraction only appeared in serum obtained from patients with various diseases, especially from patients with malignant tumours, even though the liver did not contain tumour metastases. Slow isoenzyme was found in a few sera that had alkaline phosphatase activity within the normal range. Histochemical examinations of liver tissue from patients whose serum contained the slowly migrating isoenzyme showed a pronounced reaction of alkaline phosphatase in the bile canaliculi, and this isoenzyme seems to arise from the canaliculi. The fast-migrating isoenzyme might arise from the endothelial cells of the liver, to which the activity is usually confined in histochemical stainings.     

A thermostable serum alkaline phosphatase

A more sensitive modification of the King—Armstrong method of determination of serum alkaline phosphatase has been utilised to determine the total serum alkaline phosphatase and its thermostable fraction in normal subjects and in some diseased subjects. The thermostable fraction is increased above normal in tuberculoid leprosy, but with no significant change in thalassaemia and lepromatous leprosy. Total serum alkaline phosphatase behaved oppositely with respect to these conditions.     

Automated quantification of bone and liver alkaline phosphatase isoenzymes of human serum

Coupling two Technicon AAII samplers synchronised at 50 per hour with a 2 : 1 sample to wash ratio, sera are denatured and collected automatically. The incubation is done in continuous flow by passage through a U device made of large metallic needles soaked in a water bath at 60 ± 0.1°C. This allows a very quick temperature equilibration and a very reproducible incubation time of 35 sec. Initial and residual activities of alkaline phosphatase (ALP: EC 3.1.3.1) are measured on a Rotochem II (Aminco) with the procedure recommended by the Société Franlaise de Biologie Clinique (SFBC). For a mixture of bone and liver ALP, the initial rate constant of heat denaturation K_app = (A × K_b) + (B × K₁), where A and B are the fractions of each isoenzyme in the mixture, and K_b and K₁ the rate constants for bone (b) and liver (1) experimentally determined as 1.8 min^?1 and 0.45 min^?1 respectively. An equation was derived which converts the percent residual activity to a percentage of bone and liver isoenzyme: % bone ALP = 183 ? 2.38 ×% residual activity. This automated method was applied to 2700 people of both sexes from 4 to 100 years old.