尿氨基己糖苷酶对乙醇性肝病的诊断

目的：检测乙醇性肝病（ALD）患者尿氨基己糖苷酶（uHex），并与血清中的％缺糖基转铁蛋白（％CDT）与总转铁蛋白（Tf）的比值、γ-谷氨酰转移酶（GGT）、平均红细胞容积（MCV）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）等指标比较，评价其对ALD的诊断价值。方法：选择健康不饮酒对照组、非乙醇性肝病的其他肝病组（NALD组）、ALD组（三组均为男性），分别检测uHex，％CDT，GGT，MCV，ALT，AST等指标，各指标在不同组间的比较用F检验；各项目之间的关系研究用直线相关，计算相关系数；同时绘制各指标的ROC曲线。结果：ALD组中的uHex显著高于对照组，但与NALD组无显著性差异。uHex诊断ALD的ROC曲线下面积为0．737，敏感度为0．60，特异度为0．76，而％CDT这三者分别为0．857，0．75，0．88，GGT分别为0．751，0．75，0．76，MCV分别为为0．669，0．30，0．78，ALT分别为为0．512，0．25，0．72，AST分别为为0．426，0．25，0．68。uHex与％CDT，GGT不相关，与这两者联合检测敏感度提高到1，0．9。结论：对于ALD的诊断，uHex，％CDT，GGT和MCV均具有一定的诊断价值，尤其％CDT是一个很好的辅助诊断指标，uHex也不失为一个较好的非损伤性的指标。uHex与％CDT，GGT联用可提高敏感度。

Urinary Beta-hexosaminidase,A Biochemical Marker of Alcoholic Liver Disease

Objective: To evaluate the diagnostic value of urinary beta-hexosaminidase(uHex) for alcoholic liver disease(ALD) in contrast to the ratio of carbohydrate-deficient transferrin to total transferrin(%CDT),gamma-glutamyltransferase(GGT),mean corpuscular volume(MCV),alanine aminotransferase(ALT),aspartate aminotransferase(AST). Methods: The uHex,%CDT,GGT,MCV,ALT and AST of sera of 20 cases with ALD were determined,and 30 healthy nondrinkers,20 non-alcohol-related liver diseases(NALD) also determined simultaneously. Results: The area under the ROC curve of % uHex,CDT,GGT,MCV,ALT and AST were 0.737,0.857,0.751,0.669,0.512 and 0.426,the diagnostic sensitivity were 0.60,0.75,0.75,0.30,0.25 and 0.25,and the diagnostic specificity were 0.76,0.88,0.76,0.78,0.72 and 0.68 respectively.uHex was not correlative with %CDT and GGT so we combined uHex with %CDT and GGT(either one positive) to rise the clinical sensitivity for diagnosis of ALD. Conclusion: The results indicated that %CDT was one of the best markers for ALD.uHex was a good marker too.