线粒体m-AST在肝病诊治中的应用

目的:探讨不同肝病患者血清线粒体天门冬氨酸氨基转移酶同工酶(m-A ST)的变化及其临床意义。方法:用全自动生化分析仪测定了130例不同肝病患者血清m-A ST活性。结果:肝病患者m-A ST变化与ALT、A ST变化呈正相关,且因病情不同而有不同程度的升高。急性肝炎组m-A ST明显升高,与对照组相比,升高13.3倍,其次是慢性活动性肝炎和肝硬化失代偿期,升高10.9倍和9.9倍,慢性迁延性肝炎、肝硬化代偿期、阻塞性黄疸、肝癌组m-A ST轻度升高,升高倍数分别为1.3~3.2。不同肝病患者经住院治疗2周后(第3周)随着肝功能的恢复,急性肝炎m-A ST明显下降,与入院时相比差异有极显著性,P<0.01,慢性活动性肝炎虽有下降,但与入院时相比无明显差异,P>0.05,迁延性肝炎变化不明显。肝硬化代偿期,m-A ST变化不明显,失代偿期,m-A ST持续不降,且有升高。阻塞性黄疸和肝癌治疗前后m-A ST基本无变化。结论:检测并动态观察m-A ST活性,可作为诊断急慢性肝炎,评价疗效,判断肝病预后的一项新的生化指标。

Diagnostic Value of Serum m-AST in Patients with Chronic Hepatopathy

Objective To discuss the changes of serum m-AST level and their clinical implication in patients with chronic hepatopathy.Methods Serum level of m-AST were detected in 130 cases of patients with different chronic hepatopathy.Results There were positive correlation between m-AST and ALT In different state of patients,the serum level of m-AST increased indifferent levels.Serum m-AST level of acute hepatitis increased 13.3 times as high as control,chroniclobular hepatitis and liver cirrhosis increased 10.9 and 9.9 times respectively.In groups of chronic persistent hepatitis,compensation stage of liver cirrhosis,obstructive icterus and liver cancer,the serum level of m-AST increased slightly and accounting for 1.3~3.2 times.After 2 weeks treatment,with the recovery of hepatopathy,the serum m-AST level decreased rapidly in patient with acutehepatitis and it has significant difference with that of the patient entranced to hospital(P<0.01).The serum m-AST decreased slightly in patient with chronic lobular hepatitis and the decline has nosignificant difference with that of the patient entranced to hospital(P>0.05).In chronic persistent hepatitis,compensation stage of liver cirrhosis,obstructive icterus and liver cancer groups,the serum levels of m-AST have no significant changes,before and after the treatment with patients in decomoensation stage of liver cirrhosis,it remained constant or increased.Conclusion Detection of dynamic changes of serum m-AST level can be as an effective indicator to diagnose acute or chronic hepatopathy and value the curative effect and prognosis of such diseases.