Eminler Ahmet Tarik, Irak Kader, Ayyildiz Talat, Keskin Murat, Kiyici Murat, Gurel Selim, Gulten Macit, Dolar Enver, Nak Selim Giray
Department of Gastroenterology, Uludağ University Faculty of Medicine, Bursa, Turkey.
Turk J Gastroenterol. 2014 Aug;25(4):411-5. doi: 10.5152/tjg.2014.3693.
BACKGROUND/AIMS: To investigate the relationship between gamma-glutamyl transpeptidase (GGT) levels and histopathological status determined by biopsy in patients with chronic hepatitis B and C.
Patients with chronic hepatitis B and C who were referred to the Uludağ University Faculty of Medicine Gastroenterology outpatient clinic between January 2005-January 2011 and underwent liver biopsy were included in the study. Overall, 246 patients with hepatitis B and 151 patients with hepatitis C were enrolled. According to the evaluation based on the Ishak score, patients with a histological activity index (HAI) between 0-12 were defined as low activity, and those with an HAI between 13-18 were defined as high activity. In addition, patients with a fibrosis score of 0-2 were defined as low fibrosis, and those with a score between 3-6 were defined as high fibrosis; comparisons were made accordingly.
In patients with hepatitis B, the mean GGT level was 38.86±42.4 (IU/L) in the low activity group and 60.44±44.4 (IU/L) in the high activity group (p<0.05). In hepatitis B patients, the mean GGT level was 26.89±14.83 (IU/L) in the low fibrosis group, whereas it was 65.60±59.7 (IU/L) in the high fibrosis group (p<0.001). There was no significant difference between HAI and fibrosis group with regard to GGT levels in the hepatitis C patients.
In conclusion, it is proposed that in patients with chronic viral hepatitis, GGT levels can be taken into consideration to predict advanced histological liver damage, especially in patients with hepatitis B.
背景/目的:研究慢性乙型和丙型肝炎患者中γ-谷氨酰转肽酶(GGT)水平与活检确定的组织病理学状态之间的关系。
纳入2005年1月至2011年1月间转诊至乌鲁达格大学医学院胃肠病门诊并接受肝活检的慢性乙型和丙型肝炎患者。总共纳入了246例乙型肝炎患者和151例丙型肝炎患者。根据基于伊沙克评分的评估,组织学活动指数(HAI)在0至12之间的患者被定义为低活动度,HAI在13至18之间的患者被定义为高活动度。此外,纤维化评分为0至2的患者被定义为低纤维化,评分为3至6的患者被定义为高纤维化;并据此进行比较。
在乙型肝炎患者中,低活动度组的平均GGT水平为38.86±42.4(IU/L),高活动度组为60.44±44.4(IU/L)(p<0.05)。在乙型肝炎患者中,低纤维化组的平均GGT水平为26.89±14.83(IU/L),而高纤维化组为65.60±59.7(IU/L)(p<0.001)。丙型肝炎患者的HAI和纤维化组之间的GGT水平无显著差异。
总之,建议在慢性病毒性肝炎患者中,可考虑GGT水平来预测肝脏组织学的严重损伤,尤其是在乙型肝炎患者中。