頁籤選單縮合
題名 | Value of γ-Glutamyl Transpeptidase for Early Diagnosis of Biliary Atresia=利用珈瑪麩氨酸轉胜酵素值以早期診斷先天性膽道閉鎖 |
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作者 | 劉君恕; 錢大維; 魏拙夫; Liu, Chin-su; Chin, Tai-wai; Wei, Chou-fu; |
期刊 | 中華醫學雜誌 |
出版日期 | 19981200 |
卷期 | 61:12 1998.12[民87.12] |
頁次 | 頁716-720 |
分類號 | 417.5456 |
語文 | eng |
關鍵詞 | 先天性膽道閉鎖; 珈瑪麩氨酸轉胜酵素; 新生兒肝炎; Biliary atresia; γ-glutamyl granspeptidase; Neonatal hepatitis; |
中文摘要 | 背景先天性膽道閉鎖(congenital biliary atresia)的預後與是否能及早接受 手術有非常密切的關係。 本文探討珈瑪麩氨酸轉胜酵素( GGT )值的升高能否用於早期鑑 別診斷先天性膽道閉鎖和新生兒肝炎(neonatal hepatitis)。 方法回顧並比較以出生10週內珈瑪麩氨酸轉胜酵素及其它診斷方法(包括肝臟酵素、腹部 超音波、肝膽核子醫學造影及經皮肝臟穿刺活組織切片),在29位先天性膽道閉鎖患者及 12位新生兒肝炎患者的鑑別效力。 結果(1)出生10週內珈瑪麩氨酸轉胜酵素值(若有多次則取最高值)在先天性膽道閉鎖 病患比新生兒肝炎患者有顯著意義的提高( 622.5 ± 211.9U/l 對 168.8 ± 100.3U/l, p<0.001 )。 (2)若取10週內珈瑪麩氨酸轉胜酵素值大於 300 U/l 作為診斷先天胜膽 道閉鎖的標誌,診斷的準確率為85%; 若以珈瑪麩氨酸轉胜酵素值上升速率大於 6 U/l/ 天作為診斷先天性膽道閉鎖的標準,則診斷的準確率為88%。(3)腹部超音波、肝膽核 子醫學造影及經皮肝臟穿刺活組織切片的診斷準確率分別為68%、67%及79%。 結論若其它診斷方法尚未施行或者結果無法診斷先天性膽道閉鎖時,為求及早治療,則在1 0週內珈瑪麩氨酸轉胜酵素值可作為剖腹探查的依據。 |
英文摘要 | Background. Early diagnosis of congenital biliary atresia (BA) is important because the prognosis is closely related to timing of a hepaticoportoenterostomy. In this study, we discuss whether the elevation of serum γ - glutamyl transpeptidase (GGT) is accurate for the early differentiation of BA from neonatal hepatitis (NH). Methods. The effectiveness of using GGT before the age of 10 weeks and other tools in the differential diagnosis of BA and NH were analyzed retrospectively by reviewing the charts of 29 BA and 12 NH patients. The results of serial liver enzyme studies, abdominal sonography, hepatobiliary scintigraphy and transcutaneous liver biopsy were compared between both groups. Results. The peak GGT value in BA before 10 weeks of age was significantly higher than that in NH (622.5 ± 211.9 U/l vs 168.8 ± 100.3 U/l, respectively, p<0.001). When a serum GGT concentration greater than 300 U/l was used as a diagnostic criterion for BA in patients younger than 10 weeks of age, the diagnostic accuracy was 85%. When an increase in GGT value (in serial measurements) of greater than 6 U/l/day was used as a criterion, the accuracy was 88%. The diagnostic accuracy of abdominal sonography, hepatobiliary scintigraphy and liver biopsy was 68%, 67% and 79%, respectively. Conclusions. GGT concentration is diagnostically valuable when the results of other diagnostic methods are not available, or are controversial, in differentiating between BA and NH. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。