{"title":"γ -谷氨酰转移酶在胆道闭锁诊断中的应用。","authors":"Kuo-Shu Tang, Li-Tung Huang, Ying-Hsien Huang, Chi-Yin Lai, Chi-Hung Wu, Sheng-Ming Wang, Kao-Pin Hwang, Fu-Chen Huang, Mao-Meng Tiao","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of biliary atresia (BA) is important because the prognosis is closely related to timing of Kasai operation. The aim of this study was to test the clinical application of serum gamma-glutamyl transferase (GGT) concentration and the ratio of serum GGT to aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in differentiating BA from neonatal hepatitis (NH).</p><p><strong>Methods: </strong>Ninety-three (46 male and 47 female) cases of BA and 65 (45 male and 20 female) NH were included in this study. Serum concentrations of GGT, AST, and ALT were measured in all cholestatic infants. The results of peak GGT level, GGT/AST ratio, GGT/ALT ratio were compared between groups.</p><p><strong>Results: </strong>The serum GGT levels were significantly higher in BA patients than those in NH patients (353.3 +/- 334.4 IU/L vs. 114.8 +/- 86 IU/L, P < 0.001). GGT/AST values were over 2 in 55/68 BA and 15/ 54 NH (OR = 11.0, 95% CI 4.7-25.7, P < 0.001). GGT/ALT values were over 2 in 54/65 BA and 19/50, NH respectively (OR = 8.0, 95% CI 3.4-19.0, P < 0.001). A GGT level greater than 300 IU/L had a sensitivity of 39.7% in the diagnosis of BA, GGT/AST over 2 was 80.9% and GGT/ALT over 2 was 83.1%; the specificities were 98.1%, 72.2% and 62.0%, respectively. The respective accuracies of the diagnosis of BA were 65.6%, 77.1% and 73.9%.</p><p><strong>Conclusions: </strong>GGT/AST ratio over 2 indicates high possibility of biliary atresia and should prompt further investigations to confirm the diagnosis.</p>","PeriodicalId":7156,"journal":{"name":"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gamma-glutamyl transferase in the diagnosis of biliary atresia.\",\"authors\":\"Kuo-Shu Tang, Li-Tung Huang, Ying-Hsien Huang, Chi-Yin Lai, Chi-Hung Wu, Sheng-Ming Wang, Kao-Pin Hwang, Fu-Chen Huang, Mao-Meng Tiao\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Early diagnosis of biliary atresia (BA) is important because the prognosis is closely related to timing of Kasai operation. The aim of this study was to test the clinical application of serum gamma-glutamyl transferase (GGT) concentration and the ratio of serum GGT to aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in differentiating BA from neonatal hepatitis (NH).</p><p><strong>Methods: </strong>Ninety-three (46 male and 47 female) cases of BA and 65 (45 male and 20 female) NH were included in this study. Serum concentrations of GGT, AST, and ALT were measured in all cholestatic infants. The results of peak GGT level, GGT/AST ratio, GGT/ALT ratio were compared between groups.</p><p><strong>Results: </strong>The serum GGT levels were significantly higher in BA patients than those in NH patients (353.3 +/- 334.4 IU/L vs. 114.8 +/- 86 IU/L, P < 0.001). GGT/AST values were over 2 in 55/68 BA and 15/ 54 NH (OR = 11.0, 95% CI 4.7-25.7, P < 0.001). GGT/ALT values were over 2 in 54/65 BA and 19/50, NH respectively (OR = 8.0, 95% CI 3.4-19.0, P < 0.001). A GGT level greater than 300 IU/L had a sensitivity of 39.7% in the diagnosis of BA, GGT/AST over 2 was 80.9% and GGT/ALT over 2 was 83.1%; the specificities were 98.1%, 72.2% and 62.0%, respectively. The respective accuracies of the diagnosis of BA were 65.6%, 77.1% and 73.9%.</p><p><strong>Conclusions: </strong>GGT/AST ratio over 2 indicates high possibility of biliary atresia and should prompt further investigations to confirm the diagnosis.</p>\",\"PeriodicalId\":7156,\"journal\":{\"name\":\"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2007-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:早期诊断胆道闭锁(BA)很重要，因为预后与开赛手术的时机密切相关。本研究旨在探讨血清γ -谷氨酰转移酶(GGT)浓度及其与天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)比值在新生儿肝炎(NH)与BA鉴别中的临床应用价值。方法:选取BA 93例(男46例，女47例)，NH 65例(男45例，女20例)。测定所有胆汁淤积症患儿血清中GGT、AST和ALT的浓度。比较两组间GGT峰值水平、GGT/AST比值、GGT/ALT比值。结果:BA患者血清GGT水平显著高于NH患者(353.3 +/- 334.4 IU/L vs 114.8 +/- 86 IU/L, P < 0.001)。55/68 BA和15/ 54 NH组GGT/AST值均大于2 (OR = 11.0, 95% CI 4.7 ~ 25.7, P < 0.001)。54/65 BA和19/50,NH组GGT/ALT值分别大于2 (OR = 8.0, 95% CI 3.4 ~ 19.0, P < 0.001)。GGT≥300 IU/L诊断BA的敏感性为39.7%，GGT/AST > 2的敏感性为80.9%，GGT/ALT > 2的敏感性为83.1%;特异性分别为98.1%、72.2%和62.0%。BA的诊断准确率分别为65.6%、77.1%和73.9%。结论:GGT/AST比值大于2提示胆道闭锁可能性高，应进一步检查以明确诊断。
Gamma-glutamyl transferase in the diagnosis of biliary atresia.
Background: Early diagnosis of biliary atresia (BA) is important because the prognosis is closely related to timing of Kasai operation. The aim of this study was to test the clinical application of serum gamma-glutamyl transferase (GGT) concentration and the ratio of serum GGT to aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in differentiating BA from neonatal hepatitis (NH).
Methods: Ninety-three (46 male and 47 female) cases of BA and 65 (45 male and 20 female) NH were included in this study. Serum concentrations of GGT, AST, and ALT were measured in all cholestatic infants. The results of peak GGT level, GGT/AST ratio, GGT/ALT ratio were compared between groups.
Results: The serum GGT levels were significantly higher in BA patients than those in NH patients (353.3 +/- 334.4 IU/L vs. 114.8 +/- 86 IU/L, P < 0.001). GGT/AST values were over 2 in 55/68 BA and 15/ 54 NH (OR = 11.0, 95% CI 4.7-25.7, P < 0.001). GGT/ALT values were over 2 in 54/65 BA and 19/50, NH respectively (OR = 8.0, 95% CI 3.4-19.0, P < 0.001). A GGT level greater than 300 IU/L had a sensitivity of 39.7% in the diagnosis of BA, GGT/AST over 2 was 80.9% and GGT/ALT over 2 was 83.1%; the specificities were 98.1%, 72.2% and 62.0%, respectively. The respective accuracies of the diagnosis of BA were 65.6%, 77.1% and 73.9%.
Conclusions: GGT/AST ratio over 2 indicates high possibility of biliary atresia and should prompt further investigations to confirm the diagnosis.
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