Akkaya Onder, Kiyici Murat, Yilmaz Yusuf, Ulukaya Engin, Yerci Omer
Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey.
World J Gastroenterol. 2007 Nov 7;13(41):5481-5. doi: 10.3748/wjg.v13.i41.5481.
To investigate serum alanine aminotransferase (ALT) levels in relation to the clinical, biochemical, ultrasonographic and histological characteristics of patients with hepatitis C virus.
Duration of disease, HCV-RNA, liver steatosis, and the hepatitis activity index (HAI) were correlated with serum ALT in 36 patients with HCV. ALT values were also investigated in 16 control subjects without any liver diseases.
In bivariate analyses, ALT levels correlated with duration of HCV infection (P < 0.01), HCV-RNA (P < 0.05), and the HAI (P < 0.01). Among the components of the HAI, ALT concentrations were significantly associated with periportal bridging/necrosis (P < 0.01) and fibrosis (P < 0.05). In multivariate analysis, periportal bridging/necrosis (beta = 0.508; P < 0.01), duration of HCV infection (beta = 0.413; P < 0.01), and HCV-RNA (beta = 0.253; P < 0.05) were independently associated with ALT activity. The normal ALT activity for men and women was < 23 IU/L and < 22 IU/L, respectively.
In patients with HCV, alterations in the liver tissue as reflected by ALT elevation are mainly associated with periportal bridging/necrosis, viral load and duration of disease. A cut-off value < 23 IU/L distinguished with high diagnostic accuracy healthy controls from patients with HCV.
研究丙型肝炎病毒患者血清丙氨酸氨基转移酶（ALT）水平与临床、生化、超声及组织学特征之间的关系。
对36例丙型肝炎病毒患者的病程、HCV-RNA、肝脏脂肪变性及肝炎活动指数（HAI）与血清ALT进行相关性分析。同时对16例无任何肝脏疾病的对照受试者的ALT值进行了研究。
在双变量分析中，ALT水平与HCV感染持续时间（P < 0.01）、HCV-RNA（P < 0.05）及HAI（P < 0.01）相关。在HAI的各组成部分中，ALT浓度与汇管区桥接/坏死（P < 0.01）及纤维化（P < 0.05）显著相关。多变量分析显示，汇管区桥接/坏死（β = 0.508；P < 0.01）、HCV感染持续时间（β = 0.413；P < 0.01）及HCV-RNA（β = 0.253；P < 0.05）与ALT活性独立相关。男性和女性的正常ALT活性分别< 23 IU/L和< 22 IU/L。
在丙型肝炎病毒患者中，ALT升高所反映的肝组织改变主要与汇管区桥接/坏死、病毒载量及病程有关。< 23 IU/L的临界值能以较高的诊断准确性区分健康对照与丙型肝炎病毒患者。
