Peltenburg H G, Hermens W T, Willems G M, Flendrig J G, Schmidt E
Department of Internal Medicine, Medical Faculty, University of Limburg, Maastricht, The Netherlands.
Hepatology. 1989 Nov;10(5):833-9. doi: 10.1002/hep.1840100514.
Pathological elevations of the plasma activities of liver enzymes are not simply related to the quantitative release of such enzymes from the liver. Several enzymatic indices, such as the well-known de Ritis quotient, may be determined by differences in the time course of hepatic enzyme release, rather than reflecting true differences in the released quantities of various enzymes. A more quantitative use of enzymatic data is hampered by the fact that the fractional catabolic rate constants for the elimination of enzyme activities from plasma are unknown. In the present study, three of these constants are estimated by comparison of the time-activity curves in plasma with the corresponding curve of a simultaneously released, more slowly eliminated reference enzyme. This method can be applied in patients with an acute short period of hepatic enzyme release. Values obtained for the cytosolic isoforms of lactate dehydrogenase, AST and ALT are: fractional catabolic rate constant (lactate dehydrogenase isoenzyme 5) = 0.13 +/- 0.01 hr-1, fractional catabolic rate constant (cytosolic AST) = 0.088 +/- 0.016 hr-1 and fractional catabolic rate constant (cytosolic ALT) = 0.034 +/- 0.004 hr-1 (mean +/- S.E., n = 10). These values are much higher than the apparent disappearance rate constants, because of extravascular return of activity and tailing release of enzymes during the major part of the elimination phase. It is shown that these results are consistent with earlier published data on the disappearance rates from plasma of lactate dehydrogenase, AST and ALT after acute liver injury. Cumulative release of various cytosolic enzymes occurred in proportion to the corresponding activities in human control livers.
血浆肝酶活性的病理性升高并非仅仅与肝脏中此类酶的定量释放有关。一些酶学指标,如著名的德里斯商数,可能由肝酶释放的时间进程差异所决定,而非反映各种酶释放量的真实差异。由于血浆中酶活性消除的分数分解代谢速率常数未知,酶学数据的更定量应用受到阻碍。在本研究中,通过将血浆中的时间-活性曲线与同时释放、消除更慢的参考酶的相应曲线进行比较,估计了其中三个常数。该方法可应用于肝酶急性短期释放的患者。乳酸脱氢酶、谷草转氨酶和谷丙转氨酶胞质同工型的数值如下:分数分解代谢速率常数(乳酸脱氢酶同工酶5)= 0.13 ± 0.01小时⁻¹,分数分解代谢速率常数(胞质谷草转氨酶)= 0.088 ± 0.016小时⁻¹,分数分解代谢速率常数(胞质谷丙转氨酶)= 0.034 ± 0.004小时⁻¹(均值 ± 标准误,n = 10)。由于在消除阶段的大部分时间内存在酶活性的血管外回流和酶的拖尾释放,这些数值远高于表观消失速率常数。结果表明,这些结果与先前发表的急性肝损伤后血浆中乳酸脱氢酶、谷草转氨酶和谷丙转氨酶消失率的数据一致。各种胞质酶的累积释放与人类对照肝脏中的相应活性成比例。