Muller F, Dommergues M, Ville Y, Lewin F, Delvalez-Morichon N, Nihoul-Fekete C, Bargy F, Dumez Y, Boue A
Biochimie, Hôpital Ambroise Paré, Boulogne, France.
Prenat Diagn. 1994 Oct;14(10):973-9. doi: 10.1002/pd.1970141013.
The diagnostic value of amniotic fluid gamma-glutamyl-transpeptidase (GGTP) and intestinal alkaline phosphatase (iALP) was evaluated in 55 patients who underwent amniocentesis for karyotyping because fetal gastric or small bowel dilatation had been detected by ultrasound. Gastrointestinal malformation was confirmed in 46 cases and there was no gastrointestinal anomaly in nine cases. Prenatal ultrasound was suggestive of gastroduodenal dilatation in 34 cases (group I) and small bowel dilatation in 21 cases (group II). In group I, amniotic fluid GGTP above the 99th percentile was 71 per cent sensitive and 100 per cent specific for a true anatomical defect of the digestive tract (mainly duodenal atresia). In group II, high levels of GGTP and/or iALP were 69 per cent sensitive and 83 per cent specific for a fetal digestive tract anomaly. In other words, when digestive tract dilatations were diagnosed by prenatal sonography, abnormal amniotic fluid enzyme activities were strongly suggestive of such an anomaly, the possibility of which was not precluded by normal amniotic fluid iALP and GGTP activities. But amniotic fluid digestive enzyme activities do not help in defining the prognosis.
对55例因超声检查发现胎儿胃或小肠扩张而接受羊膜穿刺术进行染色体核型分析的患者，评估了羊水γ-谷氨酰转肽酶（GGTP）和肠碱性磷酸酶（iALP）的诊断价值。46例确诊为胃肠道畸形，9例未发现胃肠道异常。产前超声提示胃十二指肠扩张34例（I组），小肠扩张21例（II组）。在I组中，羊水GGTP高于第99百分位数对真正的消化道解剖缺陷（主要是十二指肠闭锁）的敏感性为71%，特异性为100%。在II组中，GGTP和/或iALP水平升高对胎儿消化道异常的敏感性为69%，特异性为83%。换句话说，当产前超声诊断出消化道扩张时，羊水酶活性异常强烈提示存在这种异常，羊水iALP和GGTP活性正常并不能排除这种可能性。但羊水消化酶活性无助于判断预后。
