Utility of carbohydrate-deficient transferrin as a marker of relapse in alcoholic patients.
Utility of carbohydrate-deficient transferrin as a marker of relapse in alcoholic patients.
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碳水化合物缺乏的转铁蛋白作为酗酒患者复发的标志物的用途。
DOI：
10.1111/j.1530-0277.1995.tb01556.x
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Lieber,CS
中科院分区：
文献类型：
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作者：
Rosman,AS;Basu,P;Galvin,K;Lieber,CS
碳水化合物缺乏转铁蛋白（CDT）已被提议作为酒精中毒的标志物。然而，它在监测酒精患者复发方面的作用尚未得到广泛研究。因此，我们使用微柱/放射免疫测定法（Kabi Pharmacia，皮斯卡特维，NJ）对86名参与肝炎疫苗接种计划的男性酗酒者进行了连续血清CDT测量，并使用自我报告和旁系病史（如可用）监测复发情况。复吸组（n = 38）血清CDT最大值（33.1 ± 3.1mg/L）明显高于络证组（n= 39）（18.8 ± 1.3，p < 0.001）和络证组（n= 9）（17.4 ± 1.3，p < 0.01）。使用制造商目前推荐的男性阈值20 mg/L，38例复发患者中有29例血清CDT升高（敏感性76.3%）。在16例（42.1%）复发患者中，血清CDT高于该阈值，比患者自我报告提前至少28天。然而，血清CDT超过20毫克/升的48例患者中有10人保持清醒（特异性79.2%），这些患者中有三个肝硬化的临床和/或病理证据。使用25 mg/L的阈值，38例复发患者中有21例血清CDT升高（敏感性55.3%）;这些患者中有12例（31.6%）在自我报告前血清CDT升高。48例保持清醒的受试者中只有4例血清CDT水平超过25 mg/L（特异性91.7%）;其中3例患者有肝硬化的临床和/或病理证据。总之，在男性受试者自我报告之前，系列血清CDT检测可检测到复发。在20-25毫克/升之间的值提示复发，但需要进行间接验证，而CDT值高于25毫克/升通常在没有肝硬化的情况下诊断复发。
Carbohydrate‐deficient transferrin (CDT) has been proposed as a marker of alcoholism. However, its role in monitoring alcoholic patients for relapse has not been extensively studied. We therefore performed sequential serum CDT measurements using a microcolumn/radioimmunoassay method (Kabi Pharmacia, Piscataway, NJ) in 86 male alcoholics participating in a hepatitis vaccination program who were monitored for relapse using self‐report and collateral history (when available). The maximum serum CDT was significantly higher in patients who relapsed (n = 38) (33.1 ± 3.1 mg/liter), as compared with abstinent subjects with collateral verification (n= 39) (18.8 ± 1.3,p< 0.001) and abstinent patients without collateral verification (n= 9) (17.4 ± 1.3,p< 0.01). Using the manufacturer's currently recommended threshold of 20 mg/liter for males, serum CDT was elevated in 29 of 38 patients who relapsed (sensitivity 76.3%). In 16 (42.1%) of the relapsed patients, a serum CDT above this threshold preceded the patient's self‐report by at least 28 days. However, serum CDT exceeded 20 mg/liter in 10 of 48 patients who remained sober (specificity 79.2%); three of these patients had clinical and/or pathological evidence of cirrhosis. Using a threshold of 25 mg/liter, 21 of 38 patients who relapsed had an elevated serum CDT (sensitivity 55.3%); 12 (31.6%) of these patients had elevated serum CDT before self‐report. Only 4 of 48 subjects who remained sober had serum CDT levels that exceeded 25 mg/liter (specificity 91.7%); three of these patients had clinical and/or pathological evidence of cirrhosis. In conclusion, serial serum CDT testing detects relapses before self‐report in male subjects. Values between 20–25 mg/liter suggest relapse, but call for collateral verification, whereas CDT values above 25 mg/liter are usually diagnostic of relapse in the absence of cirrhosis.