Simonsen R, Virji M A
Clin Chem. 1984 Oct;30(10):1607-10.
Results of traditional laboratory tests of liver function were correlated with the clinical course in 26 pediatric patients after liver transplantation. On the basis of clinical outcome after transplantation, the patients were divided into two groups: (a) uncomplicated course with short hospital stay, and (b) post-transplantation course complicated by multiple clinical problems. The patterns of results for tests reflecting liver function--bilirubin (total and conjugated), aspartate (EC 2.6.1.1) and alanine (EC 2.6.1.2) aminotransferases, and gamma-glutamyltransferase (gamma GT, EC 2.3.2.2)--were consistent with the clinical findings in these patients. Values for alkaline phosphatase (EC 3.1.3.1), however, were only rarely increased, even when there was clinical evidence of biliary obstruction. Not only was serum gamma GT increased in obstructive jaundice, but this sometimes was the only test giving results outside the normal limits. We suggest that the persistent and marked increases of gamma GT observed in half of the patients may have resulted from immune-mediated damage to the transplanted liver.
对26例小儿肝移植患者的传统肝功能实验室检查结果与临床病程进行了相关性分析。根据移植后的临床结局，将患者分为两组：（a）病程无并发症且住院时间短；（b）移植后病程伴有多种临床问题。反映肝功能的检测指标——胆红素（总胆红素和结合胆红素）、天冬氨酸（EC 2.6.1.1）和丙氨酸（EC 2.6.1.2）氨基转移酶以及γ-谷氨酰转移酶（γ GT，EC 2.3.2.2）——的检测结果模式与这些患者的临床发现一致。然而，即使有胆道梗阻的临床证据，碱性磷酸酶（EC 3.1.3.1）的值也很少升高。不仅梗阻性黄疸患者血清γ GT升高，而且有时这是唯一一项超出正常范围的检测。我们认为，在一半的患者中观察到的γ GT持续且显著升高可能是由免疫介导的移植肝损伤所致。
