Objective To study clinical significance of lactate dehydrogenase (LDH) in diagnosis and differential diagnosis of patients with ischemic hepatitis. Methods Clinical data of 45 cases of ischemic hepatitis (IH) and 34 cases of acute viral hepatitis (AVH) were analyzed retrospectively. Results Average serum γ-Clutamyltransferase (y-CT) , alkalinephosphatase ( AKP) and total bilirubin (Tbil) were within the normal range in patients with IH, but higher above in patients with AVH. By contrary, average serum LDH increased obviously in IH but almost within the normal range in AVH. Average serum LDH value was higher in patients with cardiac ischemic hepatitis than that in hypo-volumic ischemic hepatitis. Conclusion When biochemical change such as LDH increases obviously while γ-GT, AKP and Tbil are within the normal range, ischemic hepatitis is considered firstly; when LDH increases obviously in patients with ischemic hepatitis, ischemic hepatitis induced by heart failure is considered firstly.%目的 探讨LDH在缺血性肝炎诊断与鉴别诊断中的临床意义.方法 回顾性分析45例缺血性肝炎和34例急性病毒性肝炎患者的临床特点.结果 缺血性肝炎患者,Tbil、γ-GT、AKP多在正常范围内,LDH水平则明显升高.急性病毒性肝炎与之相反,Tbil、γ-GT、AKP明显升高,LDH水平在正常范围内.心脏源性缺血性肝炎LDH水平明显升高,与失血性低血容量性缺血性肝炎患者相比,有显著差异.结论 面对明显肝功能异常的患者,若LDH明显升高,而Tbil、γ-GT、AKP水平不高,则应考虑缺血性肝炎可能,反之应考虑急性病毒性肝炎.面对LDH明显升高的缺血性肝炎患者,应首先考虑心脏功能不全引起缺血性肝炎的可能.
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