肝脏疾病患者血清酶活性与凝血四项的变化规律及辅助诊断价值研究  

The Variation and Differential Diagnosis Value of Serum Enzyme and Coagulation in Patients with Liver Disease

作　　者：谷峰[1] 陈宾[1,2] 向荣[2] 田亚平[1,2] 

机构地区：[1]解放军总医院生化科,北京100853 [2]南开大学医学院,天津300071

出　　处：《标记免疫分析与临床》2011年第4期230-232,共3页Labeled Immunoassays and Clinical Medicine

基　　金：国家科技部重大专项(2008AA02260);国家科技支撑计划(2009BAI86B05)

摘　　要：通过对ALT、AST、ALP、GGT、CHE和凝血四项的检测,探讨其在肝病鉴别诊断中的临床价值。用罗氏Modular全自动生化分析仪检测患者ALT、AST、ALP、GGT,应用强生干化学分析仪检测CHE,应用Stago检测凝血四项,经病理学和影像学确诊的35例肝炎患者、32例肝硬化患者、80例肝癌患者及50例健康体检者入选本研究。不同肝病组所测结果与正常对照组相比,除了肝炎组、肝硬化组的PT外(P>0.05),CHE指标显著降低,其余各指标均有显著增高(P<0.01或P<0.05)。肝硬化组与肝癌组相比,结果均无统计学意义。各组阳性率前四位的指标是:肝炎组,ALT>AST>GGT>CHE;肝硬化组,CHE>GGT>TT>AST;肝癌组,GGT>CHE=AST>ALT。各组诊断价值前三位的指标是:肝炎组,ALT>AST>APTT;肝硬化组,CHE>TT>APTT;肝癌组,GGT>ALP>AST。在肝炎时ALT、AST有较高的诊断价值;肝硬化时CHE、TT有较高的诊断价值;在肝癌时GGT、ALP有较高的诊断价值。To explore the value of serum markers including ALT,AST,ALP,GGT,CHE,and coagulation in differential diagnosis of liver disease.The pathologically diagnosed 35 cases of hepatitis patients,32 patients with cirrhosis,80 cases of primary liver cancer patients and 50 cases of healthy were enrolled in this study.The ALT,AST,ALP,GGT levels were detected by ROCHE Modular automatic biochemical analyzer.The CHE levels were detected with application of dry chemical analysis of Johnson,and the coagulation were detected by using stago.The results showed that the serum enzyme and coagulation levels in patients with different liver disease were significantly higher than that of in normal controls,except the PT levels in patients with hepatitis or cirrhosis（P0.05）.The CHE levels in patients were significantly reduced and the rest of the items were significantly higher（P0.01 or P0.05）.The positive rate of the first four indicators in different patients groups were as follows.The orders in hepatitis group was ALTASTGGTCHE;in cirrhosis group was CHEGGTTTAST;and in primary liver cancer group was GGTCHEALT.The diagnostic value of the top three indicators in each group were,ALTASTAPTT in hepatitis group,CHETTAPTT in cirrhosis group,and GGTALPAST in primary liver cancer group.The ALT and AST have higher diagnostic value in hepatitis,the CHE and TT have a higher diagnostic value in cirrhosis,and the GGT,CHE and ALP are helpful in diagnosing primary liver cancer.

关 键 词：ALT AST ALP GGT CHE 凝血四项 肝硬化 肝炎 肝癌 

分 类 号：R575.2[医药卫生—消化系统]