血清天门冬氨酸氨基转移酶线粒体同工酶在酒精性肝病中的临床价值

目的探讨血清天门冬氨酸氨基转移酶线粒体同工酶(m-AST)活性在酒精性肝病(ALD)预后判断中的价值。方法采用免疫抑制法检测104例ALD患者[ALD组,包括酒精性脂肪肝(AFL)36例、酒精性肝炎(AH)52例和酒精性肝硬化(AC)16例]和100例病毒性肝炎患者[非酒精性肝病(NALD)组]治疗前(入院时)、治疗3周后及100名健康成人(对照组)血清m-AST活性,同时测定血清γ-谷氨酰基转移酶(GGT)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)活性;观察AFL、AH及AC患者治疗前、后GGT、ALT、AST、m-AST活性的变化。结果 ALD组、NALD组血清GGT、ALT、AST、m-AST活性均明显高于对照组(P<0.05),NALD组各项指标明显高于ALD组(P<0.05)。治疗后AFL、AH及AC组血清GGT、ALT、AST活性均明显下降(P<0.001),AFL和AH组下降幅度明显高于AC组;AFL组血清GGT、ALT、AST、m-AST活性基本降至正常水平;AH组血清m-AST活性有明显下降,但AC组下降不明显。结论血清m-AST对ALD的治疗监测具有一定的临床意义。

Clinical significance of serum m-AST in alcoholic liver disease

Objective To investigate the prognostic significance of the serum aspartate aminotransferase mitochondrial isoenzyme(m-AST) activity in alcoholic liver disease(ALD).Methods The serum levels of m-AST,gamma-glutamyltransferase(GGT),alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were determined by immuno-inhibition assays in 104 patients with ALD,100 patients with viral hepatitis [non-ALD(NALD) group] before treatment and after treatment for 3 weeks and 100 healthy subjects(control group).The changes of serum GGT,ALT,AST,m-AST activities were observed in AFL,AH and AC patients before and after treatment.Results The activities of serum GGT,ALT,AST and m-AST in ALD and NALD groups were significantly higher than those in control group(P<0.05),and the activities in NALD group were significantly higher than those in ALD group(P<0.05).After the treatment,the GGT,ALT and AST activities in ALD group decreased significantly(P<0.001).The activities in AFL and AH groups decreased more significantly than those in AC group.After the treatment,the GGT,ALT,AST and m-AST activities decreased basically to the normal levels in AFL group.The m-AST activity decreased significantly in AH group,while the m-AST activity decreased not significantly in AC group.Conclusions Serum m-AST has clinical significance in monitoring ALD.