HBV慢性肝病尿酶活性检测的临床意义

目的探讨尿酶(LAP、NAG、GPDA)水平对HBV慢性肝病的临床意义。方法①将研究对象分为慢性肝炎组、代偿期肝炎肝硬化组、失代偿期肝炎肝硬化组以及正常对照组,测定其晨尿中LAP、NAG、GPDA水平的变化,分析各组间LAP、NAG、GPDA活性的差异;②根据肝功损害程度将所有研究对象分为轻度、中度和重度三组,比较三组间尿LAP、NAG、GPDA水平的差异;③根据HBV DNA复制的水平,将所有研究对象分为低度和高度复制两组,分析两组间尿LAP、NAG、GPDA水平的变化。结果①代偿期及失代偿期肝硬化尿NAG、LAP和GPDA水平均明显高于正常对照组及慢性肝炎组(P<0.05和P<0.01),肝硬化失代偿期尿NAG、LAP和GPDA水平均明显高于代偿期(P<0.05);②肝功损害程度与尿NAG、LAP和GPDA活性呈正相关(P<0.05和P<0.01);③HB VDNA高度复制组和低度复制组两组比较,尿NAG、LAP和GPDA水平无显著性差异(P>0.05)。结论尿LAP、NAG、GPDA活性测定可较灵敏地反映HBV慢性肝病出现的早期肾脏损害,并可间接判断慢性肝病肝功能的损害程度;尿酶(NAG、LAP和GPDA)活性与HBV DNA复制水平无明显相关性。

Clinical value of LAP, NAG and GPDA levels in urine of patients with chronic liver disease associated with HBV infection

Objective To study the clinical value of enzymes (LAP, NAG and GPDA) levels in the urine of patients with chronic liver diseases associated with HBV infection. Methods (1)All the patients were divided into chronic hepatitis group, compensated liver cirrhosis group, decompensated liver cirrhosis group and the control group. LAP, NAG and GPDA levels in their urine were detected and statistical difference between each group was studied. (2) According to the degree of liver function damage, all the cases were divided into slight, moderate and severe liver function damage groups; LAP, NAG and GPDA levels in the urine between each group were compared.(3)According to HBV DNA quantity levels, all the cases were divided into lower duplication degree group and higher duplication degree group; LAP, NAG and GPDA levels in the urine were compared among them. Results (1)LAP, NAG and GPDA levels of compensated and decompensate liver cirrhosis were higher than that of chronic hepatitis and control group(P<0.05 and P<0.01),respectively. LAP, NAG and GPDA levels of decompensated liver cirrhosis was higher than that of compensated liver cirrhosis (P<0.05).(2) Positive correlation among LAP, NAG and GPDA levels in urine and liver function damage degree can be found (P<0.05 and P<0.05).(3)No statistical difference was found between lower and higher duplication degree groups (P>0.05). Conclusion The levels of LAP, NAG and GPDA in urine can be used as a sensitive index for indicating complicated renal damage in early stage for chronic liver diseases associated with HBV infection, and also indirectly indicating the damage of liver function. The levels of enzymes (LAP, NAG and GPDA) in urine have no correlation to the degree of HBV DNA duplication