Yu Q, Pan B S
Department of Laboratory, Zhongshan Hospital of Fudan University, Shanghai 200032, China.
Zhonghua Gan Zang Bing Za Zhi. 2018 Jan 20;26(1):2-5. doi: 10.3760/cma.j.issn.1007-3418.2018.01.002.
In the recent clinical guidelines dealing with laboratory tests for liver disease evaluation, the American College of Gastroenterology (ACG) recommends ALT upper reference limits of 33 U/L for males and 25 U/L for females, and individuals with results above these "normal" cutoffs should be further investigated. Considering the differences between laboratory assays measuring ALT in our country, the uniform ACG "normal" range may not be suitable for Chinese population. On the other hand, reference upper/lower limits should not be equated with clinical decision thresholds. Simply acting in accordance with the reference range from ACG guidelines for ALT may lead to overdiagnosis and unnecessary follow-up examinations.
在近期关于肝病评估实验室检测的临床指南中，美国胃肠病学会（ACG）建议男性ALT的参考上限为33 U/L，女性为25 U/L，结果高于这些“正常”临界值的个体应进一步检查。考虑到我国测量ALT的实验室检测方法存在差异，ACG统一的“正常”范围可能不适用于中国人群。另一方面，参考上限/下限不应等同于临床决策阈值。仅仅按照ACG指南中ALT的参考范围行事可能会导致过度诊断和不必要的后续检查。
