目的 探讨血清天门冬氨酸氨基转移酶线粒体同工酶(m-AST)活性在酒精性肝病(ALD)预后判断中的价值.方法 采用免疫抑制法检测104例ALD患者[ALD组,包括酒精性脂肪肝(AFL)36例、酒精性肝炎(AH)52例和酒精性肝硬化(AC)16例]和100例病毒性肝炎患者[非酒精性肝病(NALD)组]治疗前(入院时)、治疗3周后及100名健康成人(对照组)血清m-AST活性,同时测定血清γ-谷氨酰基转移酶(GGT)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)活性;观察AFL、AH及AC患者治疗前、后GGT、ALT、AST、m-AST活性的变化.结果 ALD组、NALD组血清GGT、ALT、AST、m-AST活性均明显高于对照组(P＜0.05),NALD组各项指标明显高于ALD组(P＜0.05).治疗后AFL、AH及AC组血清GGT、ALT、AST活性均明显下降(P＜0.001),AFL和AH组下降幅度明显高于AC组;AFL组血清GGT、ALT、AST、m-AST活性基本降至正常水平;AH组血清m-AST活性有明显下降,但AC组下降不明显.结论 血清m-AST对ALD的治疗监测具有一定的临床意义.%Objective To investigate the prognostic significance of the serum aspartate aminotransferase mitochondrial isoenzyme (m-AST) activity in alcoholic liver disease (ALD). Methods The serum levels of m-AST,gamma-glutamyltransferase ( GGT) ,alanine aminotransferase ( ALT) and aspartate aminotransferase ( AST) were determined by immuno-inhibition assays in 104 patients with ALD [ALD group,including alcoholic fatty liver (AFL) 36 cases,alcoholic hepatitis (AH) 52 cases and alcoholic cirrhosis (AC) 16 cases] ,100 patients with viral hepatitis [non-ALD (NALD) group] before treatment and after treatment for 3 weeks and 100 healthy subjects (control group). The changes of serum GGT,ALT,AST,m-AST activities were observed in AFL,AH and AC patients before and after treatment. Results The activities of serum GGT,ALT,AST and m-AST in ALD and NALD groups were significantly higher than those in control group (P < 0. 05 ) ,and the activities in NALD group were significantly higher than those in ALD group (P<0.05). After the treatment,the GGT,ALT and AST activities in ALD group decreased significantly (P< 0.001). The activities in AFL and AH groups decreased more significantly than those in AC group . After the treatment,the GGT,ALT,AST and m-AST activities decreased basically to the normal levels in AFL group. The m-AST activity decreased significantly in AH group ,while the m-AST activity decreased not significantly in AC group. Conclusions Serum m-AST has clinical significance in monitoring ALD.
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