ALP、γ-GT和CHE检测在慢性乙型肝炎、肝硬化、肝癌、胆道疾病中的临床意义

探讨碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(γ-GT)、胆碱酯酶(CHE)3项检测指标对肝胆疾病诊断的临床意义。方法搜集2008年3月至2010年12月住院病例295份,其中慢性乙型肝炎78例,乙型肝炎肝硬化74例,原发性肝癌71例,胆道疾病(包括胆管结石、胆囊炎)72例,检测这些病例的ALP、γ-GT、CHE 3项指标,并随机抽查51例健康体检者作为对照,观察比较ALP、γ-GT、CHE在不同肝胆疾病中的水平。结果各组肝胆疾病患者血清中ALP和γ-GT水平均较正常对照组高(P<0.001,P<0.01);且肝癌组ALP和γ-GT水平较其他组升高更显著;肝硬化组和肝癌组与正常对照组比较CHE明显降低(P<0.001),慢性乙型肝炎组和胆道疾病组与正常对照组比较CHE无显著差异(P>0.05)。结论 ALP、γ-GT、CHE在慢性乙型肝炎、肝硬化、肝癌和胆道疾病中均有不同程度的差异。测定ALP、γ-GT有助于诊断慢性乙型肝炎、肝硬化、肝癌和胆道疾病。测定CHE有助于肝硬化和肝癌的诊断,并可评估病情的严重程度及预后。

Clinical Significance of Alkaline Phosphatase,γ-Glutamyl Transpeptidase and Cholinesterase Detection in Chronic Hepatitis B,Liver Cirrhosis,Hepatocellular Carcinoma and Biliary Tract Disease

Objective To investigate the clinical significance of alkaline phosphatase(ALP),γ-glutamyl transpeptidase(γ-GT) and cholinesterase(CHE) detection for the diagnosis of chronic hepatitis B,liver cirrhosis,liver cancer and biliary tract disease.Methods A retrospective analysis was performed in 295 patients treated between March 2008 and December 2010,including 78 patients with chronic hepatitis B,74 patients with liver cirrhosis,71 patients with primary hepatocellular carcinoma,and 72 patients with biliary tract disease(cholecystitis and cholelithiasis).The levels of serum ALP,γ-GT and CHE were detected in these patients and 51 healthy control subjects.Results The levels of ALP and γ-GT in patients were significantly higher than those in control subjects(P<0.001 or P<0.01).Furthermore,ALP and γ-GT levels in patients with primary hepatocellular carcinoma were significantly higher than those in others.Compared with control subjects,CHE levels obviously decreased in patients with liver cirrhosis or primary hepatocellular carcinoma(P<0.001),but did not changed in patients with chronic hepatitis B or biliary tract disease(P>0.05).Conclusion The levels of ALP,γ-GT and CHE are different among patients with chronic hepatitis B,liver cirrhosis,primary hepatic carcinoma and biliary tract disease.The determination of ALP and γ-GT can help to diagnose chronic hepatitis B,liver cirrhosis,primary hepatocellular carcinoma and biliary tract disease.The detection of CHE may contribute to the diagnosis of liver cirrhosis and primary hepatocellular carcinoma,and can be used to assess the disease severity and prognosis.