血清γ-谷氨酰转移酶在肝胆疾病中的临床意义

目的探讨血清γ-谷氨酰转移酶（GGT）在不同肝胆疾病中的变化及临床意义。方法检测513例不同肝胆疾病病人的血清GGT含量，并观察各组GGT的变化。结果A组（肝外胆道梗阻、肝癌、酒精性肝炎）升高最明显，与其它各组比较差异均显著（P〈0．05）。血清GGT〉正常参考值10倍以上的以肝外胆道梗阻，肝癌占的比例最高，且这二种疾病血清GGT的阳性率为100％，与ALP的敏感度相当。血清GGT含量在B组（肝硬化活动期、非酒精性脂肪肝、重度慢性乙型肝炎、中度慢性乙型肝炎）与C组（轻度慢性乙型肝炎、急性肝炎）之间比较差异亦显著（P〈0．05）。血清GGT含量在慢性乙型肝炎轻度、中度至重度依次上升，且各组之间比较差异均显著（P〈0．05）。结论GGT可以作为肝外胆道梗阻、肝癌诊断的一项敏感性指标。GGT含量能较好地反映慢性乙型肝炎的炎症活动。临床上GGT含量检测对于不同肝胆疾病的鉴别及结合其它肝功能指标对肝炎临床类型的诊断有一定的指导意义。

Clinical significance of serum GGT in liver and gall diseases

Objective To study the change and clinical significance on the serum GGT in different liver and gall diseases. Methods The concentration of serum GGT in 513 patients with different liver and gall diseases was detected, and the change in different groups was observed. Results Group A （extrahepatic obstruction of biiiary tract, liver cancer, alcoholic hepatitis） increased the most obviously, and there was significant difference than other groups （P〈0.05）. The serum GGT 〉10 times was included in extrahepatic obstruction of biliary tract and liver cancer with the highest proportion, and the positive rates of serum GGT were 100%. The sensitivity was the same as ALP. There was significant difference of the concentration of serum GGT in group B （liver cirrhosis, Nonalcoholic Fatty Liver Disease, grave chronic hepatitis B, moderate chronic hepatitis B） and group A （mild chronic hepatitis B, acute hepatitis） （P〈0.05）. The concentration of serum GGT went up gradually among mild, moderate、 and grave chronic hepatitis B, and there was significant difference each other （P〈0.05）. Conclusions GGT may be regarded as a sensitive index in diagnosis of extrahepatic obstruction of biliary tract and liver cancer. The concentration of serum GGT may show the inflammation of chronic hepatitis B, differentiate different liver and gall diseases, and guide the diagnosis of different hepatitis in combination with other liver function indexes.