摘要
目的:探讨各类肝损害患者血清对氧磷酯酶1(PON 1)活性在病程中的变化规律及其临床意义。方法:以对氧磷为底物,用速率法测定134例肝炎患者血清PON 1活性,同时测定ALT、GGT、ALP、TP和ALB水平,分析ALT、GGT、ALP、TP和ALB水平与PON 1活性的关系,并观察治疗前和治疗后血清PON 1活性的变化。结果:134例肝炎患者的PON 1活性比92例正常对照显著降低[(125．2±31.9 U／ml)vs(173.5±25．3 U／ml)],入院时PON 1活性分别为:重型肝炎(100．1±35.2)U／ml、急性肝炎(98．2±42.5)U／ml、肝炎后肝硬化(111.3±36．8)U／ml、慢性肝炎(125．3±31．2)U／ml。血清PON 1活性与ALT、GGT、ALB、ALP和TP水平有良好的相关性(r值分别为-0．663、-0．546、0．587、-0．412和- 0．393),且血清PON 1活性检测的灵敏度和特异性均优于其他指标。治疗后2周,急性肝炎组PON 1活性逐渐上升,治疗后4周和6周,急性肝炎和慢性肝炎组基本恢复正常,其他组经过治疗后,随着病情的好转,虽有上升的趋势,但变化不明显。结论:动态监测血清PON 1活性的变化有助于对肝实质细胞损伤坏死程度进行评估,有利于急性肝炎、慢性肝炎、肝炎后肝硬化和重型肝炎的预后判断,对各类肝损害疾病的诊断、疗效观察及对预后的判断均有重要的意义。
Objective：To investigate the change pattern of serum PON 1 in patients with various kinds of liver damage, as well as its clinical significances. Methods： Serum PON 1 activity was measured by using paraoxon as a substrate in 134 case of hepatitis Simultaneously, serum ALT, GGT, ALP, TP and ALB were also determined. The analysis of linear correlation was performed to estimate the relationship between these variables. Results; Serum PON 1 activity in 134 pateints with hepatitis was significantly lower than that in 92 controls [（125. 2 ± 31.9U/ml）vs（173. 5 ±25. 3 U/ml）, P〈0. 01] . Among hepatitis patients, serum PON 1 activity for patients when they first entered hospital was in the following order： severe hepatitis （100. 1 ±35. 2） U/ml, acute hepatitis （98.2 ± 42. 5） U/ml, hepatitis cirrhosis （111.3± 36. 8 ）U/ml, chronic hepatitis（ 125. 3 ±31.2） U/ml. PON 1 activity was significantly correlated with ALT, GGT, ALB, ALP, TP, respectively and PON 1 was better than others in sensitivity and specificity. After two weeks of treatment, an obvious increase in PON 1 activity in patients suffering from the acute hepatitis were found. After four and six-weeks treatment, patients suffering from the acute hepatitis and chronic hepatitis reverted to almost normal while there was no noted change in patients from hepatitis cirrhosis and severe hepatitis. Conclusion：Dynamically monitoring the change in the serum PON 1 activity may help to assess the extent which the substantial liver cells damaged and diseased, facilitating the prognosis judgment of acute hepatitis, chronic hepatitis, hepatitis cirrhosis and severe hepatitis. Serum PON 1 activity was important in evaluating the diagnosis, treatment, and prognosis of various diseases concerning liver damage.
出处
《中国临床医学》
北大核心
2006年第4期584-586,共3页
Chinese Journal of Clinical Medicine
