Jensen D M, Dickerson D D, Linderman M A, Kessler H
Section of Digestive Diseases, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL.
Arch Intern Med. 1987 Oct;147(10):1734-7.
We investigated the relationship between alanine aminotransferase (ALT) levels and the prevalence of serologic markers of hepatitis A, hepatitis B, and delta hepatitis in an outpatient population. Sera submitted for routine biochemical testing from 4669 patients were grouped according to ALT level (normal and 1 to 2.5, 2.5 to 5.0, and more than five times the upper limit of normal). Serologic evidence of acute hepatitis A or acute or chronic hepatitis B was detected in 6.1% of specimens with elevated ALT levels compared with 1.3% with normal ALT levels. Patients with ALT levels greater than 2.5-fold and fivefold elevated were associated with a 9.3% and a 15.1% prevalence, respectively, of markers of acute or chronic hepatitis. Antibody to delta hepatitis was detected in nine subjects, all of whom also had serologic evidence of chronic hepatitis B. A retrospective chart review of 80 patients with serologic evidence of acute or chronic hepatitis revealed that 51% of cases were previously undiagnosed, most of which were in the low ALT groups. Hepatitis serologic testing may be indicated in outpatients with unexplained elevations of the ALT level.
我们调查了门诊患者丙氨酸氨基转移酶（ALT）水平与甲型肝炎、乙型肝炎和丁型肝炎血清学标志物患病率之间的关系。将4669例患者提交进行常规生化检测的血清，根据ALT水平（正常以及高于正常上限1至2.5倍、2.5至5.0倍、超过5倍）进行分组。在ALT水平升高的标本中，6.1%检测到急性甲型肝炎或急性或慢性乙型肝炎的血清学证据，而ALT水平正常的标本中这一比例为1.3%。ALT水平高于正常上限2.5倍和5倍的患者，急性或慢性肝炎标志物的患病率分别为9.3%和15.1%。在9名受试者中检测到丁型肝炎抗体，所有这些受试者也有慢性乙型肝炎的血清学证据。对80例有急性或慢性肝炎血清学证据的患者进行回顾性病历审查发现，51%的病例之前未被诊断，其中大多数在ALT水平较低的组中。对于ALT水平不明原因升高的门诊患者，可能需要进行肝炎血清学检测。
