摘要
目的探讨血清线粒体型天门冬氨酸氨基转移酶同工酶(mAST)/天门冬氨酸氨基转移酶(AST)比值在肝损害病程中的变化规律及其临床意义。方法用免疫抑制法测定肝损害患者血清AST和mAST的活力,计算出mAST/AST比值,观察其在入院时与各治疗阶段的动态变化。结果正常人mAST/AST比值为(0.101±0.009),重型肝炎、酒精性肝炎、急性肝炎、药物性肝炎、肝炎性肝硬化、慢性肝炎、脂肪性肝病和原发性肝癌等入院时的mAST/AST分别为(0.482±0.096)、(0.393±0.036)、(0.332±0.046)、(0.311±0.040)、(0.289±0.032)、(0.275±0.021)、(0.301±0.047)和(0.382±0.041),均显著高于正常人(P<0.01);从治疗开始后的第1周起,酒精性肝炎组、急性肝炎组和药物性肝炎组mAST/AST比值呈逐步持续下降趋势,治疗第4周后,其mAST/AST比值已基本恢复正常;原发性肝癌组在手术1周后,尽管其mAST/AST比值明显降低,但仍显著高于正常人,且此后几周一直维持在这一较高水平;其他组的mAST/AST比值则无明显变化。结论动态监测血清mAST/AST比值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、重型肝炎的预后判断和急性肝炎与慢性肝炎鉴别诊断,对酒精性肝炎和药物性肝炎的评估和诊断治疗有指导价值。
Objective To investigate the change of serum mAST/AST ratio in patients with liver damage, as well as the clinical significance. Method Activities of the mAST and AST in patient serum were determined by immuno-inhibition assays. The mAST/AST ratio was calculated. The changes of mAST/AST ratio were determined at the time before and after hospitalization. Result The mAST/AST ratio for healthy subjects was （0.101±0.009）. Before treatment, the ratio of mAST/AST for patients with severe hepatitis, alcoholic hepatitis, acute hepatitis, drug-induced hepatitis, hepatitis cirrhosis, chronic hepatitis, fatty liver disease, and hepatocellular carcinoma was （0.482±0.096）, （0.393±0.036）, （0.332±0.046）, （0.311±0.040）, （0.289±0.032）, （0.275±0.021）, （0.301±0.047）, and （0.382±0.041 ）, respectively. The mAST/AST radio in these patients was significantly higher than the healthy subjects （P〈0.01）. The ratio of mAST/AST in patients with alcoholic hepatitis,acute hepatitis and drug-induced hepatitis was decreased starting in the first week after treatment. After four-week of treatment, the ratio of mAST/AST was returned back to a normal level. For the patients with hepatocellular carcinoma, the ratio of mAST/AST was still higher than the healthy subjects one week after the treatment. Conclusion The ratio of serum mAST/AST may be used in the assessment of liver damage in patients with acute severe hepatitis. It can also be used in diagnosis of alcohol and drug-induced hepatitis.
出处
《热带医学杂志》
CAS
2008年第6期567-569,共3页
Journal of Tropical Medicine
