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使用新型半乳糖单点法评估肝功能。

Assessment of liver function using a novel galactose single point method.

作者信息

Tang H S, Hu O Y

机构信息

Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan Republic of China.

出版信息

Digestion. 1992;52(3-4):222-31. doi: 10.1159/000200957.

Abstract

A novel, simple, clinically useful quantitative liver function test, called the galactose single point (GSP) method, was developed by measurement of galactose blood concentration 1 h after galactose was administered (0.5 g/kg). It was quickly infused intravenously in 55 normal healthy volunteers, 73 patients with chronic hepatitis (CH), 36 with cirrhosis and 41 with hepatocellular carcinoma (HCC). Patients with CH diagnosis were assessed by liver biopsy. Cirrhosis was diagnosed by histological examination or a chronic hepatitis history with esophageal varices or ascites, whereas HCC was diagnosed either histologically, or cytologically proved, or as implied in the 'one imagine study' being positive with AFP > 300 ng/dl. Highly significant galactose blood levels were observed between normal healthy volunteers and patients 50, 60 and 70 min after galactose was administered. Galactose elimination capacity (GEC), modified GEC (MGEC) and consecutive GSP tests were performed in 6 healthy volunteers for 2 days. 0.64-16.87% variation was observed for each subject. The significant differences (p < 0.001) in average GSP values were 247 +/- 18.1, 422 +/- 27.3, 629 +/- 42.8 and 579 +/- 43.6 micrograms/ml for normal healthy volunteers, CH, cirrhosis and HCC patients, respectively. Highly significant correlations (p < 0.001) were obtained among GSP, GEC and MGEC for all patients. Positive correlations were observed between GSP, GEC, MGEC and AST (serum aspartate aminotransferase), ALT (serum alanine aminotransferase), serum bilirubin, albumin, prothrombin time and r-globulin. According to results obtained from 202 normal healthy volunteers and patients, the GSP method may be a simple, clinically useful quantitative measurement of liver function for the determination of a patient's residual liver function, the prognosis of liver function for patients with cirrhosis, postoperational follow-up and, finally, the timing of a liver transplant.

摘要

一种名为半乳糖单点(GSP)法的新型、简单且临床实用的定量肝功能测试方法,是通过在给予半乳糖(0.5 g/kg)后1小时测量血液中的半乳糖浓度而开发的。在55名正常健康志愿者、73名慢性肝炎(CH)患者、36名肝硬化患者和41名肝细胞癌(HCC)患者中快速静脉输注半乳糖。CH诊断患者通过肝活检进行评估。肝硬化通过组织学检查或伴有食管静脉曲张或腹水的慢性肝炎病史进行诊断,而HCC则通过组织学或细胞学证实,或如“一项影像学研究”中所暗示的,甲胎蛋白(AFP)> 300 ng/dl呈阳性。在给予半乳糖后50、60和70分钟时,正常健康志愿者与患者之间观察到了高度显著的半乳糖血药浓度。对6名健康志愿者进行了为期2天的半乳糖清除能力(GEC)、改良GEC(MGEC)和连续GSP测试。每个受试者的变异范围为0.64 - 16.87%。正常健康志愿者、CH、肝硬化和HCC患者的平均GSP值的显著差异(p < 0.001)分别为247 ± 18.1、422 ± 27.3、629 ± 42.8和579 ± 43.6微克/毫升。所有患者的GSP、GEC和MGEC之间均获得了高度显著的相关性(p < 0.001)。GSP、GEC、MGEC与天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、血清胆红素、白蛋白、凝血酶原时间和γ球蛋白之间观察到正相关。根据从202名正常健康志愿者和患者获得的结果,GSP方法可能是一种简单、临床实用的肝功能定量测量方法,可用于确定患者的残余肝功能、肝硬化患者的肝功能预后、术后随访,最终用于确定肝移植的时机。

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