慢性乙型肝炎肝功能与肝组织炎症的关系

目的 :探讨慢性乙型肝炎 (CHB)、血清丙氨酸氨基转移酶 (ALT)、天门冬氨酸基转移酶 (AST)和谷氨酰转肽酶 (GGT)水平与肝组织炎症病理分级间的关系。方法 :885例CHB肝活检期间常规检测血清ALT、AST和GGT ,取峰值与肝组织炎症G1、G2、G3 和G4进行分析比较。结果 :肝组织炎症G1时 ,仅有血清ALT均值超出正常值上限。血清ALT和AST均值在G1、G2 和G3 间及血清GGT均值在G2、G3 和G4 间比较差异均有显著性 (P<0 001)。血清GGT均值在G1 与G1 间比较差异也有显著性 (P<0 01)。90 %以上的中重度CHB的ALT、AST和GGT水平均升高。在ALT、AST和GGT正常的CHB中 ,中重度CHB(包括早期肝硬化 )分别占17 5 %、13 4 %和20 9 %。结论 :评价活动性轻、中度CHB ,血清ALT和AST较敏感 ;评价活动性中、重度CHB ,血清GGT较敏感。

Relationship between the value of serum ALT,AST,GGT and the hepatic pathological inflammation grade in patients of CHB

Objective:To explore the relationship between the value of serum ALT,AST,GGT and the hepatic pathological inflammation grade in patients of CHB.Methods:885 patients of CHB were performed liver biopsy and were classified as G1,G2,G3 and G4 group according to hepatic inflammatory activity.Serum ALT,AST and GGT were tested.The correlation between the value of ALT,AST,GGT and the hepatic pathological inflammation grade was analysed.Results:Only the mean value of ALT in above normal value in G1 group.The mean values of ALT and AST were significantly different among G1,G2,G3 groups,the mean value of GGT was significantly different among G2,G3,G4 groups(P<0.001).The mean value of GGT was significantly different between G1 and G2 groups,too(P<0.01).ALT,AST and GGT were elevated in more than 90% moderate and severe CHB patients.There were 17.5%,13.4%,20.9% were moderate and severe CHB(including incipient cirrhosis) in the patients with normal ALT,AST or GGT,respectively.Conclusion:Serum ALT and AST were more sensitive indexes to evaluate the hepatic inflammatory activity with mild and moderate CHB,while serum GGT was more sensitive index to evaluate the hepatic inflammatory activity with moderate and severe CHB.