慢性肝病患者血清腺苷脱氨酶测定的临床意义

目的探讨腺苷脱氨酶（ADA）在慢性乙型肝炎中的应用价值。方法应用OLYMPUS AU640全自动生化分析仪检测ADA及各项肝功能指标，放射免疫法检测肝纤维化指标，对其中36例患者做肝活组织检查。结果从慢性乙型肝炎病毒携带者、轻度慢性肝炎、重度慢性肝炎至肝硬化，患者血清ADA水平逐渐升高（p=0．000）。在行肝活组织检查的36例患者中，肝硬化患者ADA水平也高于慢性肝炎患者（P=0．0t6）。血清ADA与血清门天冬氨酸氨基转移酶（AST）、球蛋白、门静脉宽度、脾脏厚度、Ⅲ型前胶原（PCm）呈明显正相关（r=0．391，P=0．000；r=0．261，P=0．000；r=0．336，P=0．002；r=0．611，P=0．000；r=0．391，P=0．000），与白蛋白、胆碱酯酶（ChE）呈明显负相关（r=-0．352，P=0．000；r=-0．200，P=0．005）。结论血清ADA水平随乙型肝炎的病情进展逐渐升高，能较好地反映肝脏的储备功能，并在一定程度上体现肝纤维化的活动情况。

The clinical significance of serum adenosine deaminase determination in chronic hepatitis B patients

Objective To investigate the clinical significance of adenosine deaminase （ADA） in chronic hepatitis B patients. Methods The ADA and liver function indexes were determined by OLYMPUS AU6d-0. The fibrosis indexes were detected by radioimmunoassay （RIA）. Liver biopsies were done in 36 patients. Results The serum ADA increased gradually from HBV carriers, mild chronic hepatitis, severe chronic hepatitis to liver cirrhosis （P = 0.000）. In patients with liver biopsies, The levels of ADA in liver cirrhosis patients were higher than that in chronic hepatitis patients（P = 0.016）. The serum ADA level was correlated positively with serum asparate aminotransferase, globulin, the width of portal vein, the thickness of spleen and type HI procollagen （ r = 0.391, P = 0.000 ; r = 0. 261, P = 0,000, r = 0.336, P = 0.002 ; r = 0.611, P = 0. 000 ; r = 0.391, P = 0. 000 ）, it was correlated negatively with serum albumin and cholinesterase（ r = - 0. 352 ,P = 0. 000 ; r = - 0. 200, P = 0.005）. Conclusions The level of ADA increases with the pathogenetic condition advancement of chronic viral hepatitis B patients, it could reflect the decrease of liver function, and active liver fibrosis in a certain extent.