Zamin Júnior Idilio, de Mattos Angelo Alves, Perin Christiano, Ramos Gabriel Zatti
Faculdade Federal de Ciências Médicas de Porto Alegre (FFFCMPA) e Irmandade Santa Casa de Misericórdia de Porto Alegre.
Arq Gastroenterol. 2002 Jan-Mar;39(1):22-6. doi: 10.1590/s0004-28032002000100005.
BACKGROUND/AIMS: There is a histologic similarity between nonalcoholic steatohepatitis and alcoholic liver disease and in some cases differential diagnosis may be difficult, since some patients do not report abusive alcohol consumption.
Evaluating the usefulness of setting the rate AST/ALT for the differential diagnosis of nonalcoholic steatohepatitis and alcoholic liver disease.
Twenty nine obese patients with nonalcoholic steatohepatitis were compared with 28 patients with alcoholic liver disease. The diagnosis of nonalcoholic steatohepatitis was made after exclusion of other causes of liver disease and by histologic findings of, at least, macrovesicular steatosis and hepatocellular necrosis.
In patients with nonalcoholic steatohepatitis the medium AST value was 52.3 +/- 21.2 U/L and ALT of 90.1 +/- 37.9 U/L, being the AST/ALT rate lower than 1 in all patients. In patients with alcoholic liver disease the medium AST value was 140 +/- 82.5 U/L and ALT was 50.6 +/- 40.3 U/L. The rate was higher than 1 in all cases and higher than 2 in 24 (85.7%), being statistically significant when compared with patients with nonalcoholic steatohepatitis.
The AST/ALT rate seems to be useful in the differential diagnosis of liver diseases, while lower than 1 is highly suggestive of nonalcoholic steatohepatitis.
背景/目的：非酒精性脂肪性肝炎与酒精性肝病在组织学上存在相似性，在某些情况下鉴别诊断可能困难，因为一些患者未报告有酗酒情况。
评估设定AST/ALT比值对非酒精性脂肪性肝炎和酒精性肝病进行鉴别诊断的实用性。
将29例非酒精性脂肪性肝炎肥胖患者与28例酒精性肝病患者进行比较。非酒精性脂肪性肝炎的诊断是在排除其他肝病病因后，根据至少存在大泡性脂肪变性和肝细胞坏死的组织学表现做出的。
非酒精性脂肪性肝炎患者的AST中位数为52.3±21.2 U/L，ALT为90.1±37.9 U/L，所有患者的AST/ALT比值均低于1。酒精性肝病患者的AST中位数为140±82.5 U/L，ALT为50.6±40.3 U/L。所有病例该比值均高于1，24例（85.7%）高于2，与非酒精性脂肪性肝炎患者相比有统计学意义。
AST/ALT比值似乎对肝病鉴别诊断有用，低于1高度提示非酒精性脂肪性肝炎。
