血清谷氨酸脱氢酶与其他肝功能指标联合检测在肝病诊断中的临床意义  

Clinical significance of combined detection of serum glutamate dehydrogenase and other liver function indexes in the diagnosis of liver disease

作　　者：李小侠[1] LI Xiaoxia(Department of Clinical Laboratory,Shaanxi Provincial People’s Hospital,Xi’an 710068)

机构地区：[1]陕西省人民医院检验科,西安710068

出　　处：《陕西医学杂志》2020年第12期1677-1680,共4页Shaanxi Medical Journal

摘　　要：目的:探讨肝细胞损伤时谷氨酸脱氢酶(GLDH)变化特点及其与总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)和胆碱酯酶(CHE)等指标联合检测在肝病诊断中的临床意义。方法:选取肝病患者240例(肝病组)作为研究对象,其中急性病毒性肝炎69例(急性肝炎组),慢性活动性肝炎52例(慢活肝组),慢性迁延性肝炎49例(慢迁肝组),肝硬化43例(肝硬化组),原发性肝癌27例(肝癌组)。选取同期健康体检者100例作为对照组。检测血清中GLDH、TBA、ALT、AST、GGT和CHE水平并进行比较。结果:不同肝病组血清GLDH、TBA、ALT、AST、GGT水平均高于对照组,CHE水平均低于对照组(均P<0.05)。GLDH异常率从高到低依次为急性肝炎组、肝硬化组、慢活肝组、肝癌组和慢迁肝组。ALT和AST异常率由高到低依次为急性肝炎组、慢活肝组、肝癌组、慢迁肝组和肝硬化组。TBA异常率由高到低依次为急性肝炎组、慢活肝组、肝硬化组、肝癌组和慢迁肝组。GGT异常率由高到低依次为肝癌组、急性肝炎组、肝硬化组、慢活肝组和慢迁肝组。CHE异常率由低到高依次为肝硬化组、慢活肝组、肝癌组、急性肝炎组和慢迁肝组。结论:GLDH可作为肝细胞损伤的特异性指标,与血清TBA、ALT、AST、GGT和CHE等肝功能指标联合检测对肝细胞损伤程度的综合评估及对肝病的鉴别诊断具有重要意义。Objective:To investigate the changes of GLDH in hepatocyte injury and the clinical significance of combined detection of GLDH,TBA,ALT,AST,GGT and CHE in the diagnosis of liver diseases.Methods:240 patients with liver disease(liver disease group)were selected as the research objects,including 69 cases of acute viral hepatitis(acute hepatitis group),52 cases of chronic active hepatitis(chronic active liver group),49 cases of chronic persistent hepatitis(chronic progressive liver group),43 cases of liver cirrhosis(cirrhosis group)and 27 cases of primary liver cancer(liver cancer group).100 healthy people were selected as the control group.The serum levels of GLDH,TBA,ALT,AST,GGT and CHE were detected and compared.Results:The serum levels of GLDH,TBA,ALT,AST and GGT in different liver disease groups were higher than those in the control group,and the CHE level was lower than that in the control group(all P<0.05).The abnormal rate of GLDH from high to low was acute hepatitis group,cirrhosis group,chronic active liver group,liver cancer group and chronic progressive liver group.The abnormal rates of ALT and AST from high to low were acute hepatitis group,chronic active liver group,liver cancer group,chronic progressive liver group and cirrhosis group.The abnormal rate of TBA from high to low was acute hepatitis group,chronic active liver group,cirrhosis group,liver cancer group and chronic progressive liver group.The abnormal rate of GGT from high to low was liver cancer group,acute hepatitis group,cirrhosis group,chronic active liver group and chronic progressive liver group.The abnormal rate of CHE from low to high were cirrhosis group,chronic active liver group,liver cancer group,acute hepatitis group and chronic liver disease group.Conclusion:GLDH can be used as a specific indicator of hepatocyte injury.Combined detection of GLDH with serum TBA,ALT,AST,GGT and CHE is of great significance for comprehensive evaluation of hepatocyte injury and differential diagnosis of liver disease.

关 键 词：谷氨酸脱氢酶 肝功能指标 联合检测 肝病 

分 类 号：R575[医药卫生—消化系统]