血清精氨酸代琥珀酸裂解酶的测定在肝病诊断中的意义

目的探讨血清精氨酸代琥珀酸裂解酶（ASL）对肝病的诊断效能。方法测定291例肝病患者、247例非肝病患者和32名健康对照血清ASL和ALT、AST、GGT、LDH、ALP活性及TBil浓度；其中31例肝病患者进行了病理组织学检查。结果ROC曲线显示ASL对判断肝病的敏感度为100．0％，特异性为91．1％（分界值=8．0U／L）；ALT和AST的敏感度为97．60%和83．8％，特异性仅分别为24．7％和28．3％（分界值=40．0U／L）。ASL在不同肝病的变化情况是肝癌〉急性肝炎〉肝硬化〉慢性肝炎；ASL浓度（86．9±26．5）u／L]与肝病理组织学炎症活动度计分（9．83±3．36）呈正相关（r=0．417，P=0．019）。结论ASL诊断肝病的敏感度、特异性优于AST和ALT，是肝病诊断的有用指标。

Determination of serum argininosuccinate lyase in diagnosing liver diseases

OBJECTIVE: To investigate the value of the determination of the levels of serum argininosuccinate lyase (ASL) in diagnosing various liver diseases. METHODS: Two hundred and ninety-one patients with various liver diseases, 257 patients with non-liver disease, and 32 healthy controls were recruited for this study and their serum ASL, ALT, AST, GGT, LDH, ALP, and total bilirubin (TBil) levels were determined. Liver biopsies were performed on 31 patients with hepatopathy. RESULTS: Receiver operating characteristic (ROC) curve analysis showed that the sensitivity and specificity of ASL in assessing liver diseases were 100% and 91.1% (at cut-off values of 8 U/L), those of ALT were 97.6% and 24.7% and those of AST were 83.8% and 28.3% (both at cut-off values = 40.0 U/L), respectively. The levels of ASL in various liver disease patients were: in liver cancer - acute hepatitis - liver cirrhosis - chronic hepatitis. A positive correlation (r = 0.417) was observed between serum ASL levels (86.9+/-26.5) and scores of histopathological inflammation grading (9.83+/-3.36). CONCLUSION: ASL is of higher sensitivity and specificity than those of ALT and AST for diagnosing liver diseases. ASL may be used as a useful marker in estimating hepatopathy.