Pasqualetti P, Festuccia V, MacCarone C, Di Lauro G, Casale R
Dipartimento di Medicina Interna e Sanità Pubblica, Università degli Studi, L'Aquila.
Minerva Med. 1995 Oct;86(10):395-402.
In order to assess the diagnostic value of serum gamma-glutamyl-transpeptidase (GGT) and mean corpuscular volume (MCV) as markers of alcoholism in chronic liver diseases, 107 patients with non-alcoholic chronic liver disease and 192 patients with alcoholic liver disèases have been compared. GGT and MCV values were checked two times: the day of admission to hospital and 10 days after complete withdrawal from alcohol. The patients with alcoholic liver diseases present significantly higher values of GGT and MCV in respect with patients with non-alcoholic liver diseases. A significant (p < 0.05) decrease of about 50% in serum GGT levels and of about 3% in MCV was observed after alcohol withdrawal only in the group of alcoholic liver diseases whereas no changes were found in the other group of patients: For the diagnosis of alcoholism in chronic liver diseases, while the sensitivity and the specificity of the several markers vary from 50% to 86%, the positive predictive values of GGT and MCV at admission were 92.2% and 73.4%, and the negative predictive values were 40.2% and 75.7%, respectively. Moreover, the positive predictive values of GGT and MCV after 10 days of alcohol withdrawal were 95.3% and 85.9% and the negative predictive values were 31.8% and 46.7%, respectively. The contemporary decrease in GGT and MCV values does not seem to offer better informations than GGT decrease. These data suggest that, even if GGT and MCV do appear per se as weak indicators of alcoholism during chronic liver diseases, the early decrease in their values, especially in serum GGT, are good and specific markers of alcohol abuse and, consequently, of the alcoholic etiology of liver disease.
为了评估血清γ-谷氨酰转肽酶（GGT）和平均红细胞体积（MCV）作为慢性肝病中酒精中毒标志物的诊断价值，对107例非酒精性慢性肝病患者和192例酒精性肝病患者进行了比较。对GGT和MCV值进行了两次检查：入院当天以及完全戒酒10天后。与非酒精性肝病患者相比，酒精性肝病患者的GGT和MCV值明显更高。仅在酒精性肝病组中，戒酒10天后血清GGT水平显著降低约50%，MCV降低约3%，而另一组患者未发现变化：对于慢性肝病中酒精中毒的诊断，虽然几种标志物的敏感性和特异性在50%至86%之间变化，但入院时GGT和MCV的阳性预测值分别为92.2%和73.4%，阴性预测值分别为40.2%和75.7%。此外，戒酒10天后GGT和MCV的阳性预测值分别为95.3%和85.9%，阴性预测值分别为31.8%和46.7%。GGT和MCV值同时降低似乎并不比GGT降低提供更好的信息。这些数据表明，即使GGT和MCV本身在慢性肝病期间似乎是酒精中毒的弱指标，但其值的早期降低，尤其是血清GGT的降低，是酒精滥用以及肝病酒精性病因的良好且特异性标志物。
