Office of Pharmacovigilance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Federal Research Center at White Oak, Silver Spring, Maryland, USA.
Clin Pharmacol Ther. 2012 Sep;92(3):332-9. doi: 10.1038/clpt.2012.108. Epub 2012 Aug 8.
Assay of the serum activity of the enzyme alanine aminotransferase (ALT) has become the primary screening tool for detecting acute liver injury. But what does an elevated value mean? Not what it is too often mistakenly believed to indicate. It is not a test of liver function. It does not necessarily predict worse effects to come (in a given person). It is not a valid measure of severity of liver injury or dysfunction. It is too unspecific to be reliable in screening for relatively rare effects on the liver. Although these are substantial limitations, ALT is a very useful biomarker if understood and used properly. It is important to consider how and why these erroneous concepts came to have such wide acceptance, and how elevations of ALT activity for evaluating patients and subjects under study might be interpreted better.
血清丙氨酸氨基转移酶（ALT）活性检测已成为诊断急性肝损伤的主要筛选工具。但是，升高意味着什么呢？这并不像人们常常错误认为的那样。它不是肝功能测试。它不一定预示着更严重的后果（对特定个体而言）。它也不是衡量肝损伤或功能障碍严重程度的有效指标。由于其特异性低，在筛查相对罕见的肝脏效应时，它并不可靠。尽管存在这些局限性，但如果正确理解和使用，ALT 仍是一种非常有用的生物标志物。重要的是要考虑这些错误概念是如何以及为何被广泛接受的，以及如何更好地解释 ALT 活性升高在评估患者和研究对象中的作用。
