心脏瓣膜置换术对5′-磷酸吡哆醛依赖的血清ALT、AST活力检测的影响  

Effect of heart valve replacement surgery on pyridoxal 5′-phosphate dependent detection of serum ALT and AST activities

作　　者：奚静洁 俞雯雯 凌震 倪布清 张洁心 XI Jingjie;YU Wenwen;LING Zhen(Department of Clinical Laboratory,Jiangyin People's Hospital,Jiangyin 214400,CHINA)

机构地区：[1]江阴市人民医院检验科,江苏214400 [2]南京医科大学第一附属医院(江苏省人民医院)检验学部 [3]南京医科大学第一附属医院(江苏省人民医院)心脏大血管外科

出　　处：《江苏医药》2024年第2期129-132,共4页Jiangsu Medical Journal

基　　金：江苏省大学生创新创业训练计划项目(202210312072Y)。

摘　　要：目的探讨心脏瓣膜置换术(HVR)对5′-磷酸吡哆醛依赖的血清ALT、AST活力检测的影响。方法收集接受单个瓣膜HVR的22例患者术前、术后即刻、术后第1天、术后第2天和术后第3天的血清标本,不同时间点血清ALT和AST活力均分别采用VITROS 5600干生化分析仪(干片法)和Beckman Coulter AU5800型全自动生化分析仪(试剂法)检测。计算两种方法检测ALT和AST活力的测量偏倚。测量不同时间点的血磷浓度。结果22例HVR患者术前肝功能及肾功能指标均在正常范围内。术后第2天和第3天ALT活力测量偏倚高于术后第1天(P<0.05)。术后第3天的AST活力测量偏倚高于术后即刻和术后第1天(P<0.05)。女性患者术后第3天ALT活力测量偏倚高于术后第1天(P<0.05)。术后各时间点血磷浓度均低于术前(P<0.05);术后第1天血磷浓度低于其余时间点(P<0.05)。结论HVR患者术后ALT活力测量偏倚增大可能与低浓度血磷有关。HVR患者术后采用含5′-磷酸吡哆醛的干片法检测可得到更准确的血清ALT活力,有助于病情变化的临床监测。Objective To explore the effect of heart valve replacement(HVR)surgery on pyridoxal 5′-phosphate dependent detection of serum ALT and AST activities.Methods Serum samples were collected from 22patients undergoing single valve HVR at the time points of before surgery,immediately after surgery and on the 1st,2nd,3rd day after surgery.Serum ALT and AST activities were measured using VITROS 5600dry biochemical analyzer(dry slice method)and Beckman Coulter AU5800fully automatic biochemical analyzer(reagent method),respectively.The measurement bias values for detecting ALT and AST activities by the two methods were calculated.The blood phosphorus concentration of the patients was measured as well.Results The preoperative liver and kidney function indicators of 22 HVR patients were within the normal ranges.The measurement bias of ALT activity on the 2nd and 3rd day was higher than that on the 1st day after surgery(P<0.05).The measurement bias of AST activity on the 3rd day after surgery was higher than that at the times of immediately and on the 1st day after surgery(P<0.05).The measurement bias of ALT activity on the 3rd day after surgery was higher than that on the 1st day after surgery in female patients(P<0.05).The blood phosphorus concentration was lower after operation than that before(P<0.05),which on the 1st day after surgery was lower than that at the other time points(P<0.05).Conclusion The increased bias of postoperative ALT viability measurement in HVR patients may be related to low concentrations of serum phosphorus.The more accurate serum ALT activity level can be obtained with the dry slice method pyridoxal 5′-phosphate dependent test,which is helpful for clinical monitoring of disease changes.

关 键 词：心脏瓣膜置换术 丙氨酸氨基转移酶 天冬氨酸氨基转移酶 5′-磷酸吡哆醛 血磷 

分 类 号：R446[医药卫生—诊断学]