Center S A, Slater M R, Manwarren T, Prymak K
Department of Clinical Sciences, New York State College of Veterinary Medicine, Cornell University, Ithaca 14853.
J Am Vet Med Assoc. 1992 Oct 15;201(8):1258-64.
The diagnostic efficacy of serum alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT) activities was examined, using the records of 270 dogs initially suspected of having hepatobiliary disease on the basis of history, findings on physical examination, results of baseline screening tests, or any combination of these data. Histologic examination of hepatic tissue was performed in each dog. Sixty-three dogs did not have histologic evidence of hepatobiliary disease and served as the control group. On the basis of diagnosis, dogs were assigned to 1 of 8 groups: dogs with cirrhosis (n = 34), steroid hepatopathy (n = 16), hepatic neoplasia (primary and secondary, n = 36), chronic hepatitis (n = 14), chronic passive congestion (n = 5), hepatic necrosis (n = 17), portosystemic vascular anomaly (n = 35), and cholestasis (extrahepatic bile-duct obstruction and intrahepatic cholestasis, n = 50). Of the 207 dogs with hepatobiliary disease, 29 (14%) had normal ALP and GGT activities, 31 (15%) had normal ALP activity, and 112 (54%) had normal GGT activity. Of the 63 control dogs, 29 (46%) had normal serum ALP and GGT activities, 32 had normal ALP activity (ALP specificity, 51%), and 55 had normal GGT activity (GGT specificity, 87%). The specificity of ALP and GGT in parallel (positive result = result of either test abnormal) was 46%, and in series (positive result = results of both tests abnormal) was 91%. The highest median activities of ALP developed in dogs with cholestasis, steroid hepatopathy, chronic hepatitis, and hepatic necrosis. The highest median activities of GGT developed in dogs with steroid hepatopathy, cholestasis, and hepatic necrosis.(ABSTRACT TRUNCATED AT 250 WORDS)
通过270只最初基于病史、体格检查结果、基线筛查测试结果或这些数据的任意组合而疑似患有肝胆疾病的犬只记录,对血清碱性磷酸酶(ALP)和γ-谷氨酰转移酶(GGT)活性的诊断效能进行了检查。对每只犬的肝组织进行了组织学检查。63只犬没有肝胆疾病的组织学证据,并作为对照组。根据诊断结果,将犬只分为8组中的1组:肝硬化犬(n = 34)、类固醇性肝病犬(n = 16)、肝肿瘤(原发性和继发性,n = 36)、慢性肝炎犬(n = 14)、慢性被动性淤血犬(n = 5)、肝坏死犬(n = 17)、门体循环血管异常犬(n = 35)和胆汁淤积犬(肝外胆管梗阻和肝内胆汁淤积,n = 50)。在207只患有肝胆疾病的犬中,29只(14%)的ALP和GGT活性正常,31只(15%)的ALP活性正常,112只(54%)的GGT活性正常。在63只对照犬中,29只(46%)的血清ALP和GGT活性正常,32只ALP活性正常(ALP特异性为51%),55只GGT活性正常(GGT特异性为87%)。ALP和GGT并行(阳性结果 = 任一测试结果异常)的特异性为46%,串联(阳性结果 = 两项测试结果均异常)的特异性为91%。胆汁淤积、类固醇性肝病、慢性肝炎和肝坏死犬的ALP中位数活性最高。类固醇性肝病、胆汁淤积和肝坏死犬的GGT中位数活性最高。(摘要截取自250字)