Development of enzyme-linked immunosorbent assay as a liver function test

我们开发了一种灵敏的酶联免疫吸附试验（ELISA）血清鸟氨酸氨甲酰转移酶（OCT）蛋白，并检查血清OCT浓度在各种肝病患者。OCT浓度在肝性脑病、“慢性加急性”和急性肝炎急性期病例中显著升高，在慢性肝炎、肝硬化、肝细胞癌、原发性胆汁性肝硬化病例中中度升高，在脂肪肝病例中轻度升高。慢性肝炎、肝硬化和肝癌患者血清OCT蛋白浓度高于正常值的比例较高（92-94%）。与谷草转氨酶（AST）和谷丙转氨酶（ALT）活性密切相关，与线粒体AST、谷氨酸脱氢酶和谷氨酰转肽酶中度相关。肝硬化组OCT/ALT比值高于慢性肝炎组（P<0.001），肝癌组OCT/ALT比值仍高于慢性肝炎组（P<0.05）。在2例“急性慢性”患者中，OCT浓度在入院后与AST或ALT活性相似或更快地下降。在2例肝性脑病患者中，OCT浓度与AST和ALT活性变化相似。该OCT ELISA系统可用于各种肝病的诊断和随访，OCT/ALT比值可用于肝病的鉴别诊断。

We developed a sensitive enzyme-linked immunosorbent assay (ELISA) for serum ornithine carbamoyltransferase (OCT) protein, and examined serum OCT concentrations in patients with various liver diseases. OCT concentrations were markedly elevated in cases of hepatic encephalopathy, "acute on chronic", and those with the acute phase of acute hepatitis, moderately in chronic hepatitis, Iiver cirrhosis, hepatocellular carcinoma, primary biliary cirrhosis, and slightly in those with a fatty Iiver. High percentages (92-94%) of patients with chronic hepatitis , liver cirrhosis and hepatocellular carcinoma had higher than normal concentration of serum OCT protein. There was a close correlation with aspartateaminotransferase (AST) and alanine aminotransferase (ALT) activities and moderate correlations with those of mitochondrial AST,glutamate dehydrogenase and g-glutamyl transpeptidase. The OCT/ALT ratio was higher in patients with liver cirrhosis than in those with chronic hepatitis (P<0.001), and was still higher in cases of hepatocellular carcinoma (P<0.05). In two patients with "acute on chronic", OCT concentrations decreased similarly with or more rapidly than AST or ALT activities after admission. In two patients with hepatic encephalopathy, the OCT concentrations changed similarly with AST and ALT activities. This OCT ELISA system will aid in diagnosing various liver diseases and for follow of the patients, and the OCT/ALTratio may serve for a differential diagnosis of liver diseases.