Alvarez Lucia, Whittemore Jacqueline
University of Tennessee, USA.
Compend Contin Educ Vet. 2009 Sep;31(9):408-10, 412-3; quiz 414.
Increased liver enzyme activities are sensitive indicators of primary hepatic disease, but they are also associated with extrahepatic diseases. The patient's signalment, clinical status, and pattern of liver enzyme activity can help in interpreting findings. The three basic liver enzyme patterns are (1) cholestatic, (2) hepatocellular leakage, and (3) mixed. Predominant increases in the activities of the cholestatic or inducible enzymes, alkaline phosphatase and I(3)-glutamyl transpeptidase, occur with endocrine disorders, cholestasis, neoplasia, benign nodular hepatic hyperplasia, and administration of certain drugs and occur idiopathically in certain breeds. Predominant increases in the activities of the hepatocellular leakage enzymes, alanine aminotransferase and aspartate aminotransferase, occur with circulatory disturbances, hepatotoxicities, infectious diseases, hepatitis, and neoplasia. A mixed pattern of increased liver enzyme activities may occur with hepatotoxicity or concurrent cholestasis and hepatocellular injury or necrosis.
肝酶活性升高是原发性肝脏疾病的敏感指标，但也与肝外疾病有关。患畜的特征、临床状况和肝酶活性模式有助于解释检查结果。三种基本的肝酶模式为：（1）胆汁淤积型，（2）肝细胞漏出型，（3）混合型。胆汁淤积或诱导性酶（碱性磷酸酶和γ-谷氨酰转肽酶）活性显著升高见于内分泌紊乱、胆汁淤积、肿瘤、良性结节性肝增生、某些药物的使用，以及某些品种的特发性情况。肝细胞漏出酶（丙氨酸氨基转移酶和天冬氨酸氨基转移酶）活性显著升高见于循环障碍、肝毒性、传染病、肝炎和肿瘤。肝酶活性升高的混合型可能见于肝毒性或并发胆汁淤积及肝细胞损伤或坏死。
