Lum G
Pathology and Laboratory Medicine Service, Brockton/West Roxbury Veterans Affairs Medical Center, Boston, MA, USA.
Clin Chem. 1995 Apr;41(4):515-8.
The causes for low serum alkaline phosphatase (ALP) activity (reference range 30-115 U/L) in a large Veterans Medical Center were reviewed. Of 69,864 ALP determinations made over a 4-year period, 130 were low (< 30 U/L, 0.19%), representing 88 individual patients. Of these, 83 (primarily men, 96%) patients' charts were reviewed and classified into two groups, those with and those without conditions previously reported to be associated with decreased serum ALP activity: 47% had conditions associated with low ALP activity, the most frequent being cardiac surgery and cardiopulmonary bypass (26.5%), malnutrition (12.0%), magnesium deficiency (4.8%), hypothyroidism (2.4%), and severe anemia (1.2%); 53% of patients did not have clinical conditions previously associated with low ALP activity. No case of clinically apparent hypophosphatasia, for which low ALP activity is the defining characteristic, was found in this population of veterans. A low serum ALP may be of significance in other patient populations such as children, where it is associated with achondroplasia and cretinism, or in postmenopausal women with osteoporosis taking estrogen replacement therapy. In the predominantly adult male population in this study, low ALP activity was rare; it was seen most frequently in cardiac surgery patients postoperatively, a clinical condition heretofore not commonly associated with low serum ALP activity.
对一家大型退伍军人医疗中心血清碱性磷酸酶（ALP）活性降低（参考范围30 - 115 U/L）的原因进行了回顾。在4年期间进行的69864次ALP测定中，有130次结果偏低（<30 U/L，占0.19%），涉及88例个体患者。其中，对83例（主要为男性，占96%）患者的病历进行了回顾，并分为两组，一组患有先前报道与血清ALP活性降低相关的疾病，另一组则没有：47%的患者患有与低ALP活性相关的疾病，最常见的是心脏手术和体外循环（26.5%）、营养不良（12.0%）、镁缺乏（4.8%）、甲状腺功能减退（2.4%）和严重贫血（1.2%）；53%的患者没有先前与低ALP活性相关的临床疾病。在这群退伍军人中，未发现以低ALP活性为特征性表现的临床明显低磷酸酯酶症病例。血清ALP降低在其他患者群体中可能具有重要意义，例如在儿童中，它与软骨发育不全和呆小症有关，或者在接受雌激素替代治疗的绝经后骨质疏松女性中也有意义。在本研究中以成年男性为主的人群中，低ALP活性很少见；最常见于心脏手术后的患者，而这种临床情况以前通常与低血清ALP活性无关。
