AST／ALT比值在各种肝病中的变化和意义

目的 通过观察急、慢性乙型肝炎、丙型肝炎＼肝硬化、脂肪肝患者的谷草转氨酶（ＡＳＴ）／谷丙转氨酶（ＡＬＴ）比值变化，探讨ＡＳＴ／ＡＬＴ应用于诊断肝纤维化、肝硬化的可能性。方法 测定各种肝病患者的ＡＳＴ、ＡＬＴ水平和ＡＳＴ／ＡＬＴ比值，对慢性乙型肝炎，肝硬化患者的ＡＳＴ／ＡＬＴ比值与 ＨＡ、ＬＮ、ＩＶ－Ｃ的相关性进行分析。透射电镜观察脂肪肝、慢性乙型肝炎、肝硬化病人肝组织超微结构。结果 肝硬化患者ＡＳＴ／ＡＬＴ比值明显高于其他肝病患者（Ｐ＜０．００１），慢性乙型肝炎患者明显高于急性乙型肝炎（Ｐ＜０．００１）。以ＡＳＴ／ＡＬＴ≥１区分肝硬化和慢性乙型肝炎，其特异性和灵敏性分别为９６％、１００％，这一比值与肝纤维化指标（ＨＡ、ＬＮ、ＩＶ－Ｃ）呈正相关。结论ＡＳＴ／ＡＬＴ比值是肝脏疾病向慢性化进展和肝硬化的一个良好诊断指标。

Change and clinical significance of AST/ALT ratio in various liver diseases

Objective To detecte the ration of AST/ALT in several liver diseases, including cirrhosis, acute and chronic hepatitis B, hepatitis C, fatty liver , and by to evaluate the utility of the AST/ALT ratio in patients with hepatic fibrosis and cirrhosis. Methods The levels of serum AST/ALT and ratio of AST/ALT were determined with various forms of liver disease, Correlations between the AST/ALT ratio and serum HA; LN and IV - C values in chronic hepatitis B and cirrhosis were assessed. The ultrastracture of liver biopsy was observed in normal liver, fatry liver , chronic hepatitis B and cirrhotic patients with transmission electricity. Results The mean ratio AST/ALT in cirrhotic patients was significantly higher than in the noncirrhotic patients (P < 0.001) , and that of AST/ALT in active and static stage of chronic hepatitis B was significantly higher than in acute hepatitis B ,The ratio of one or more had 91 percent specificity and 100 pertent sensitinity in distinguishing cirrhotic from chronic hepatitis B pa- tients. There were statistically significant correlations between the AST/ALT ratio and serum HA, LN, IV - C val- ues. Conclusion The AST/ALT ration is a useful index of liver disease progression and diagnoned cirrhosis.