Kanitz R D, Wood W G, Wetterling T, Forster J, Oehler G
Department of Psychiatry, Medical University of Lübeck, FRG.
Prog Neuropsychopharmacol Biol Psychiatry. 1994 May;18(3):431-46. doi: 10.1016/0278-5846(94)90002-7.
Carbohydrate deficient transferrin (CDTect-RIA, Pharmacia) was compared with an Immunoluminometric assay for isotransferrin separated by a short column Con-A sepharose which we have called alcohol mediated triantennary transferrin (AMT). 101 in-patients with alcohol dependency syndrome (alcohol consumption of more than 60 g/day) were grouped according to the time of abstinence A1 (0-7 days), A2 (8-14 days), A3 (> or = 15 days). Serum samples were obtained at admission (U0) and under abstinent conditions after 10-20 days (U1). All groups were controlled for AMT, CDT, GGT, MCV. Control groups were 30 in-patients with non alcoholic liver disease (NALD) and 31 healthy volunteers (alcohol consumption of less than 20g/day). Results showed for CDT and AMT highly significant differences between short abstinence period (group A1) and more than two weeks abstinence (group A3) alcoholics and between group A1 and healthy controls. In group A1 CDT was significantly elevated (P < or = .001) compared to NALD group whereas AMT showed no differences. CDT (cut off 22 mg/l) showed a high diagnostic specificity (A1/controls 97%, A1/NALD 83%, A1/A3 78%) but only a diagnostic sensitivity of 61%. AMT (cut off 260 mg/l) revealed a diagnostic test sensitivity of 74%. The diagnostic test specificity of AMT was inferior to CDT (A1/controls 74%, A1/NALD 50%, A1/A3 70%). Initial CDT and AMT values in alcoholics were highly correlated (P < or = .001) with time of abstinence. CDT and AMT decline was correlated with time of abstinence. CDT was proved for high significant (P < or = .001) decline over a longer period of abstinence (11-30 days) while AMT decline was significant (P = .008) only in early abstinence (0-10 days). Presence of a withdrawal syndrome was highly correlated (P < or = .01) with CDT values above 22 mg/l and AMT values above 260 mg/l. Furthermore in selected follow up cases it was shown that AMT seemed to be a more sensitive indicator for short alcoholic relapses than CDT.
将碳水化合物缺乏转铁蛋白（CDTect-RIA，Pharmacia公司）与我们称为酒精介导的三分支转铁蛋白（AMT）的通过短柱Con-A琼脂糖分离的异转铁蛋白免疫发光测定法进行比较。101例酒精依赖综合征患者（每日酒精摄入量超过60克）根据戒酒时间分为A1组（0 - 7天）、A2组（8 - 14天）、A3组（≥15天）。在入院时（U0）和戒酒10 - 20天后（U1）获取血清样本。所有组均检测AMT、CDT、γ-谷氨酰转移酶（GGT）、平均红细胞体积（MCV）。对照组为30例非酒精性肝病（NALD）住院患者和31名健康志愿者（每日酒精摄入量少于20克）。结果显示，短戒酒期（A1组）与戒酒超过两周（A3组）的酗酒者之间以及A1组与健康对照组之间，CDT和AMT存在高度显著差异。在A1组中，与NALD组相比，CDT显著升高（P≤0.001），而AMT无差异。CDT（临界值22毫克/升）显示出较高的诊断特异性（A1组/对照组97%，A1组/NALD组83%，A1组/A3组78%），但诊断敏感性仅为61%。AMT（临界值260毫克/升）的诊断试验敏感性为74%。AMT的诊断试验特异性低于CDT（A1组/对照组为74%，A1组/NALD组为50%，A1组/A3组为70%）。酗酒者最初的CDT和AMT值与戒酒时间高度相关（P≤0.001）。CDT和AMT的下降与戒酒时间相关。在较长戒酒期（11 - 30天）内，CDT下降高度显著（P≤0.001），而AMT仅在早期戒酒（0 - 10天）时下降显著（P = 0.008）。戒断综合征的存在与CDT值高于22毫克/升和AMT值高于260毫克/升高度相关（P≤0.01）。此外，在选定的随访病例中显示，AMT似乎比CDT更能敏感地指示短期酗酒复发情况。
