缺糖基转铁蛋白对酒精性肝病的诊断

目的 检测酒精性肝病(ALD)患者血清中的缺糖基转铁蛋白(CDT)与总TI的比值％CDT，并与GGT、MCV、ALT、AST等指标比较，评价其对ALD的诊断价值。方法 选择健康不饮酒对照组、非酒精性肝病的其他肝病组(NALD组)、ALD组(3组均为男性)，分别检测％CDT、GGT、MCV、ALT、AST等指标，各指标在不同组间的比较用F检验；各项目之间的关系研究用直线相关，计算相关系数；同时绘制各指标的ROC曲线。结果 ALD组中的％CDT显著高于对照组、NAID组。％CDT诊断ALD的ROC曲线下面积为0．857，敏感度0．75，特异度0．88，而GGT这三者分别为0．751、0．75、0．76，MCV分别为0．669、0．30、0．78，ALT分别为0．512、0．25、0．72，AST分别为0．426、0．25、0．68。％CDT、与GGT不相关，但两者联合检测敏感度提高到90％。结论 对于ALD的诊断，％CDT、GGT、MCV均具有一定的诊断价值，尤其％CDT是一个很好的辅助诊断指标。％CDT与GGT联用可提高敏感度。

Carbohydrate-deficient transferrin,a biochemical marker of alcoholic liver disease

Objective To evaluate the diagnostic value of the ratio of carbohydrate-deficient transferrin (CDT) to total transferrin (%CDT) in alcoholic liver disease (ALD) and compare it with gamma-glutamyltransferase (GGT),mean corpuscular volume (MCV),alanine aminotransferase (ALT),aspartate aminotransferase (AST).Methods The %CDT,GGT,MCV,ALT and AST were determined in serum samples of 20 cases with ALD,30 healthy nondrinkers and 20 non-alcohol-related liver diseases (NALD) simultaneously.Results The area under the ROC curve of %CDT,GGT,MCV,ALT and AST were 0.857,0.751,0.669,0.512 and 0.426,the diagnostic sensitivity were 0.75,0.75,0.30,0.25 and 0.25,and the diagnostic specificity were 0.88,0.76,0.78,0.72 and 0.68 respectively.The %CDT was not correlative with GGT but the determination of %CDT combined with GGT (either positive) elevated the clinical sensitivity to 0.9 for diagnosis of ALD.Conclusion The %CDT is a better marker for diagnosis of ALD than GGT and MCV.