血浆谷氨酸脱氢酶活性测定在肝胆疾病中的临床应用评价

摘要

Objective:To investigate the clinical significance of glutamate dehydrogenase (GLDH)in patients with liver dis-ease.Methods:A total of 229 patients with liver disease (25 patients with acute hepatitis,60 CHB patients,47 patients with liver cir-rhosis,31 patients with liver failure,29 patients with biliary obstruction,37 patients with liver carcinoma)and 120 healthy subjects were enrolled.The liver enzymes of GLDH,AST,ALT,ALT and GGT were determined.Results:The activity of GLDH in liver diseases,espe-cially in patients with biliary obstruction and liver carcinoma,were significantly higher than that in healthy controls (P <0.05).The ra-tio of GLDH to AST in patients with biliary obstruction was significantly higher than that in healthy controls (P <0.05).The activities of GLDH closely related to the severity of liver damage and correlated with AST (r =0.230,P <0.001 ).Conclusion:The activity of GLDH was significantly increased in patients with biliary obstruction and liver carcinoma,and may be a biochemical marker for diagno-sing and evaluating the liver injury.%目的：探讨血浆谷氨酸脱氢酶（glutamate dehydrogenase，GLDH）活性测定在肝脏疾病中的临床意义。方法：采用速率法检测229例肝功能异常者（急性肝损伤25例；慢性乙型肝炎60例；肝硬化47例；肝衰竭31例；胆道梗阻性疾病29例；肝癌37例）及120例健康体检者（作为对照组）的血浆 GLDH 活性，并与 AST、ALT、ALT、GGT 等常用肝胆疾病指标进行比较分析。结果：本室采用速率法测定 GLDH 活性的参考区间为4．4～13．3 U ／L。胆道梗阻性疾病和肝癌患者血浆 GLDH 较对照组明显升高（P ＜0．05），胆道梗阻性疾病患者的 GLDH ／AST 比值也明显高于对照组（P ＜0．05）。血浆 GLDH 浓度与 AST浓度呈显著的正相关（r ＝0．230，P ＜0.001）。血浆 GLDH 浓度与肝损伤程度相关，随病情好转而降低。结论：胆道梗阻性疾病和肝癌患者血浆 GLDH 升高最为明显，GLDH 可作为判断肝细胞损伤程度和疗效观察的指标。