免疫抑制法测定肝脏病患者血清mAST活性的临床意义

目的] 了解mAST活性在肝病诊断和病情评估的意义。方法] 在全自动生化分析仪上用mAST免疫抑制法试剂盒测定83名正常人及430例病毒性肝炎患者（急性肝炎70例、慢性肝炎82例、肝硬化80例、重肝39例、肝癌76例）的血清mAST活性。结果]mAST正常参考上限为14．5U／L，mAST／AST参考范围为0．234～0．626。急性肝炎组mAST绝对值明显高于其他组，但阳性率较低。肝癌和重肝组，mAST升高亦明显，与正常对照组差异显著，而且阳性率较高，分别达到85．5％、89．7％。mAST／AST在各组肝病中（除慢肝外）均比正常组降低，阳性率均很低。mAST在用于诊断肝病时，如果只用于区分正常和肝病，诊断效率较高，ROC曲线下面积（AUC）达到0．893；如果对各种肝病细分，在各种肝病中，mAST诊断重型肝炎的ROC曲线下面积（AUC）最大达0．749，诊断效率最高。结论]血清mAST是在反映肝细胞损伤时，有一定的使用价值。

Clinical significance of determination of serum mAST by immunosuppressive method in patients with liver disease

Objective] To determine the clinical diagnostic value of the changes in activity of serum mAST in patients with liver disease. nethods] The activity of serum mAST was determined with immunosuppressive method in 430 patients with liver disease and 83 healthy individuals. Results] The normal reference of mAST was limited up to 14.5 U/L and that of mAST/AST 0. 234 -0. 626. The absolute value of mAST was significantly higher but positive rate lower in the patients with acute hepatitis than in healthy individuals. Both the mean value and positive rate of mAST were markedly higher in patients with severe hepatitis or liver cancer than in the healthy individuals. The AUC was 0. 893 when mAST was used to differentiate patients with liver disease from healthy individuals. The AUC was the highest in patients with severe hepatitis. Conclusion] The changes in activity of serum mAST is valuable for determination of liver cell injury.