血清GLD和(ALT+AST)/GLD比值对肝病诊断的临床探讨

目的:探讨谷氨酸脱氢酶(GLD)和(ALT+AST)/GLD比值在肝细胞损伤疾病患者鉴别诊断中的应用价值。方法:收集53例健康者和166例不同肝病患者的血清标本,按临床诊断分为7组,在日立7600-020型全自动生化分析仪上同时测定GLD活性和(ALT+AST)/GLD比值。结果:不同肝病患者血清中GLD活性均高于健康者,其中在急性缺血性肝炎和急性中毒性肝坏死时GLD升高幅度最大,与正常对照组差异有显著性(P<0.01),其阳性率均可达100%。急性病毒性肝炎的(ALT+AST)/GLD比值为68.3,较其他各疾病组显著升高,而急性缺血性肝炎、急性中毒性肝坏死和原发性肝癌患者(ALT+AST)/GLD比值分别为4.5、4.2和5.5,不增高。结论:检测GLD活性和(ALT+AST)/GLD比值对各种肝病的鉴别诊断、疗效观察及预后判断有着独特的临床应用价值。

Determination of Serum Glutamate Dehydrogenase and (ALT + AST)/GLD for the Differential Diagnosis of Liver Disease Patients

Objective To study the value of the determination of glutamate dehydrogenase and (ALT+AST)/GLD in the differential diagnosis of liver diseases patients. Methods Sera of 53 healthy controls and 156 patients with different liver diseases. Which divided into seven groups by the clinical diagnosis, were collected and GLD and (ALT+AST)/GLD were detected simultaneously by HITACHI-7600 biochemical analyzer. Results The results of GLD in sera of different liver diseases were higher than those of the healthy controls. And GLD lever as the highest in acute ischemic hepatitis and acute toxic liver necrosis. And had significant difference from healthy controls(P<0.01).In acute ischemic hepatitis and acute toxic liver necrosis, the positive rates were 100%. (ALT+AST)/GLD of acute viral hepatitis was 71.3, much higher than other liver diseases. (ALT+AST)/GLD of acute ischemic hepatitis, acute toxic liver necrosis and liver cancer were separately 4.5, 3.2 and 5.1, not rising. Conclusion The determination of serum glutamate dehydrogenase and (ALT+AST)/GLD is great significance for the different diagnosis of hepatic diseases, specially the hepatogenic and necrotic hepatopathy.