Wietholtz H, Colombo J P
Schweiz Med Wochenschr. 1976 Jul 17;106(29):981-7.
90 chronic alcoholics (55 men and 35 women, aged between 20 and 60 years) were investigated to determine how alcohol withdrawal effects the pattern of enzymes in plasma and if changes in this enzyme pattern could be used as criteria for evaluation of the recovery process. Among the different enzymes tested, gamma-glutamyl-transpeptidase (GGTP) and the transamines seemed the most suitable parameters. At the beginning of the alcohol withdrawal course, 79 out of 90 patients (80%) showed elevated values of one of these enzymes in plasma. GOT was elevated in 31 (34%), GPT in 24 (23%) and GGTP in 79 (88%) of the cases. In 49 patients (54%) GGTP was the only enzyme found to be elevated. The values of GGTP were on the average higher than those of GOT and GPT. GGTP has thereforeto be regarded as the most sensitive enzyme since it was elevated in most of the patients. GGTP reacted with 6.8 times more sensitivity than GOT and 6.3 times that of GPT. After withdrawal of alcohol the three enzymes showed a decline in all 79 patients. The transaminases normalized faster than GGTP. GTP fell into the upper normal limit after only 30 days. Among the 90 alcoholics examined, 14 relapsed during the alcohol withdrawal course. After the new excess of alcohol intake, the GGTP in plasma rose immediately. Alcohol abuse was suspected in 50% of the patients due to the increase in this enzyme and was subsequently confirmed by the patients. Acute alcohol loading in normal volunteers did not lead to an increase in GGTP activity. A comparison of the histology of liver biopsy material showed that neither the transaminases nor the alkaline phosphatase and GGTP served to differentiate the various forms of alcoholic liver damage. However, GGTP represents the most sensitive enzymatic parameter for the detection of alcoholic liver disease. This enzyme is useful in evaluating the success of a course of alcohol deprivation. The decreasing values during such treatment, as well as the prompt increase after a relapse, points to the high sensitivity of this enzyme. A further argument is that in 54% of the patients elevation of GGTP only was present. Since no liver damage could be demonstrated in these patients with the aid of the other liver enzymes, the elevation of GGTP may be related to the alcohol intake through an enzyme induction mechanism such as has been demonstrated for this enzyme with certain drugs.
对90名慢性酗酒者（55名男性和35名女性，年龄在20至60岁之间）进行了调查，以确定戒酒如何影响血浆中的酶模式，以及这种酶模式的变化是否可作为评估恢复过程的标准。在测试的不同酶中，γ-谷氨酰转肽酶（GGTP）和转氨酶似乎是最合适的参数。在戒酒过程开始时，90名患者中有79名（80%）血浆中这些酶中的一种值升高。31例（34%）谷草转氨酶（GOT）升高，24例（23%）谷丙转氨酶（GPT）升高，79例（88%）GGTP升高。在49名患者（54%）中，发现只有GGTP升高。GGTP的值平均高于GOT和GPT的值。因此，GGTP应被视为最敏感的酶，因为大多数患者中它都升高了。GGTP的反应灵敏度比GOT高6.8倍，比GPT高6.3倍。戒酒之后，所有79名患者的这三种酶都出现了下降。转氨酶比GGTP恢复正常的速度更快。GTP仅在30天后就降至正常上限。在接受检查的90名酗酒者中，有14人在戒酒过程中复发。在再次过量饮酒后，血浆中的GGTP立即升高。由于这种酶的升高，50%的患者被怀疑存在酒精滥用，随后得到了患者的证实。正常志愿者急性饮酒并未导致GGTP活性增加。对肝活检材料组织学的比较表明，转氨酶、碱性磷酸酶和GGTP均无法区分各种形式的酒精性肝损伤。然而，GGTP是检测酒精性肝病最敏感的酶学参数。这种酶有助于评估戒酒疗程的成效。在这种治疗过程中其值下降，以及复发后迅速升高，都表明了这种酶的高灵敏度。另一个论据是，54%的患者仅出现GGTP升高。由于借助其他肝酶在这些患者中未发现肝损伤，GGTP的升高可能通过一种酶诱导机制与酒精摄入有关，就像已证实这种酶与某些药物存在这种关系一样。
