胆汁型碱性磷酸酶同工酶在恶性肝外胆道阻塞诊断中的价值

目的 探讨胆汁型碱性磷酸酶同工酶在恶性肝外胆道阻塞论断中的价值。方法 用改良琼脂糖电泳对30例健康体检者和105例肝胆疾病患者血清中的碱性磷酶同工酶（ALP）进行分离和定量分析。结果 恶性肝外胆道阻塞的胆汁型ALP显著高于非恶性肝外胆道阻塞、肝内梗阻性黄疸以及原发性肝癌，正常体验者血清中不存在胆汁型ALP；若以100U／L的胆汁型ALP区分恶性肝外胆道阻塞和其他肝胆疾病，则它对恶性外胆道阻塞的诊断灵敏度为82．9％，特异性为95％，阳性预示值为85．3％，阴性预示值为94．1％，实验总有效率为91．9％。结论 胆汁型ALP可作为恶性肝外胆道阻塞的有用诊断指标。

The Value of Bile Alkaline Phosphatase Isoenzyme in Diagnosis of Malignant Extrahepatic Biliary Obstruction.

Aim To investigate the value of bile alkaline phosphatase isoenzyme in diagnosis of malignant extrahepatic biliary obstruction.Methods Bile alkaline phosphatase isoenzymes were measured by improved agarose electrophoresis in the serum which was from 30 normal control subjects and 105 patients with hepatobiliary diseases.Results The mean value of this isoenzyme in patients with malignant extrahepatic obstruction was significantly higher than that of patients with benign extrahepatic obstruction,as well as intrahepatic cholestasis and primary liver cancer.Furthermore,we could not detect this isoenzyme in normal individuals.When 100 U/L was used as a cut off value to discriminate patients with malignant extrahepatic obstruction from other hepatobiliary disorders,the sensitivity,specificity,positive and negative indication of the test were 82.9 percent,95 percent,85.3 percent,94.1 percent,respectively.Conclusions Bile alkaline phosphatase isoenzyme could be a useful marker in diagnosis of malignant extrahepatic biliary obstruction.