肝病患者精氨酸代琥珀酸裂解酶分泌及与肝病相关血清学指标的关系.docVIP

精品论文 参考文献 肝病患者精氨酸代琥珀酸裂解酶分泌及与肝病相关血清学指标的关系 湖北省武汉市普仁医院 湖北武汉 430081 摘要：目的 探讨肝脏疾病时精氨酸代琥珀酸裂解酶（argininosuccinate lyase，ASL）分泌及与肝病相关血清学指标的关系。方法 随机选择102例明确诊断的肝病患者，测定血清ASL、甘氨酸胆酸（GCA）、谷丙转氨酶（ALT）和谷草转氨酶（AST），与71例非肝病患者以及40例健康体检者（健康对照组）进行对照比较。结果 肝病组血清ASL水平显著高于非肝病组和健康对照组（均Plt;0.01），而非肝病组和健康对照组间无显著性差异；GCA、ALT和AST三组间均有显著性差异（均Plt;0.01）。受试者工作特征曲线（ROC Curve）显示ASL诊断肝病疾病的诊断效率高于GCA、ALT和AST，相关性分析显示肝病患者血清ASL水平与GCA、ALT、AST呈正相关性（r=0.618，Plt;0.01；r=0.473，Plt;0.01；r=0.433，Plt;0.01）。结论 ASL是反映肝脏疾病的灵敏指标，与常见的肝病血清学诊断指标有关联性，且诊断效率最高，适合临床开展。 关键词：精氨酸代琥珀酸裂解酶，肝病，血清 [Abstract]Objective：To investigate the relationship between argininosuccinate lyses（ASL）and other liver related serum markers on patients with liver disease.Methods：102 patients with liver diseases，71 patients with non-liver diseases and 40 healthy controls were recruited for this study and their serum ASL，GCA，ALT and AST were detected.Results：The level of serum ASL in liver disease group was significantly higher than that in non-liver disease group or healthy control group（all plt;0.01），and there were no significant difference between the non-liver disease group and healthy control group.The results of serum GCA，ALT and AST revealed significant difference among these three groups（all plt;0.01）.Receiver operating characteristic（ROC）curve analysis showed that ASL is superior to other serum markers in diagnosing liver disease.Furthermore ASL showed a positive correlation with GCA，ALT and AST（r=0.618，plt;0.01；r=0.473，plt;0.01；r=0.433，plt;0.01）.Conclusion our date suggest that ASL is superior to those GCA，ALT or AST，and ASL is a more valuable serum marker for diagnosing of liver diseases. [Key words]argininosuccinate lyase，liver disease，serum 肝脏疾病在我国的疾病谱中占有很大比例，每年因肝病死亡的人数居高不下，早期的诊断和治疗对于肝病的控制极其重要。血清学诊断是最方便、快捷的肝病诊断手段，目前广泛应用于临床的肝脏损伤标志物多为谷丙转氨酶（ALT）、谷草转氨酶（AST）和甘氨酸胆酸（glycocholic acid，简称GCA）等，但这些指标对于肝病的诊断缺乏特异性，在鉴别诊断中的应用受到限制。近年来，国外一些学者研究发现在肝脏中催化合成尿素的一系列酶中精氨酸代琥珀酸裂解酶（（argininosuccinate lyase，ASL）对于诊断肝病具有独特的优势[1]。本研究通过对肝病患者血清A