Biochemical Evaluation of Patients of Alcoholic Liver Disease and Non-alcoholic Liver Disease
Biochemical Evaluation of Patients of Alcoholic Liver Disease and Non-alcoholic Liver Disease
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DOI：
10.1007/s12291-013-0310-7
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发表时间：
2014-01-01
影响因子：
2.1
通讯作者：
Bhute, A. K.
中科院分区：
文献类型：
--
作者：
Torkadi, Prasad P.;Apte, I. C.;Bhute, A. K.
酒精性肝病（ALD）是由于长期过量饮酒造成的。ALD与非ALD（非酒精性脂肪性肝炎，病毒性肝炎）的区别是困难的，因为患者可能会否认酒精滥用。临床检查，组织学和血清学可能无法区分这些条件。准确的诊断是重要的，因为ALD的管理不同于非ALD患者。本研究的目的是：（1）通过与对照组比较，评估ALD和非ALD患者的生化指标，（2）评估这些指标是否可以区分ALD和非ALD。Ⅰ组为ALD患者50例，Ⅱ组为非酒精性脂肪性肝炎（NASH）和急性病毒性肝炎各35例。年龄匹配的健康对照组n = 50。选择标准-饮酒史（量和持续时间）、临床检查、腹部超声检查、血清丙氨酸转氨酶（ALT）和胆红素水平。采用动力学方法检测胆红素、谷草转氨酶（AST）、谷丙转氨酶（ALT）、碱性磷酸酶（ALP）、γ谷氨酰转移酶（GGT）。通过Student非配对t检验进行统计分析。ALD患者AST/ALT比值（De Ritis比值）（[ 2]）、ALP、GGT均高于对照组（P < 0.01）。ALD组AST/ALT比值、血清GGT、ALP与NASH、急性病毒性肝炎比较差异有显著性（P < 0.05）。这项研究表明，酒精性肝病患者的De Ritis比率[ 2]可能是由于酒精诱导的肝线粒体损伤和吡哆醇缺乏所致。高GGT和ALP值可能表明酒精和轻度胆汁淤积的酶诱导。因此，ALD患者具有严重的肝损伤。德里蒂斯比率
Alcoholic liver disease (ALD) is due to excessive alcohol intake for long duration. Distinguishing ALD from non-ALD (non-alcoholic steatohepatitis, hepatitis of viral origin) is difficult as patient may deny alcohol abuse. Clinical examination, histology and serology may not differentiate these conditions. Accurate diagnosis is important as management of ALD differs from non-ALD patients. The aim of our study was (1) To evaluate the patients of ALD and non-ALD by biochemical parameters compared to controls, (2) To assess whether these parameters can differentiate ALD from non-ALD. Study was carried out on 50 patients of ALD in group I and 35 patients of NASH (non-alcoholic steatohepatitis) and acute viral hepatitis each in group II. Age matched healthy controls n = 50. Selection criteria-history of alcohol intake (amount and duration), clinical examination, sonography of abdomen, serum alanine transaminase (ALT) and bilirubin levels. Blood samples were analyzed for bilirubin, aspartate transaminase (AST), ALT, alkaline phosphatase (ALP), gamma glutamyl transferase (GGT) by kinetic method. Statistical analysis was done by Student unpaired 't' test. Patients of ALD have raised AST/ALT ratio (De Ritis ratio) ([ 2), ALP and GGT compared to controls (P < 0.01). There is significant difference in AST/ALT ratio, serum GGT and ALP in ALD group compared to that in NASH and acute viral hepatitis (P < 0.05). This study suggests that De Ritis ratio[ 2 in ALD patients may be due to alcohol induced hepatic mitochondrial injury and pyridoxine deficiency. High GGT and ALP values may indicate enzyme induction by alcohol and mild cholestasis. Thus ALD patients have severe hepatic damage. De Ritis ratio