Study on Diagnostic Value of Determination of Liver Enzymology in Liver Disease

Objective To evaluate the diagnostic value of the examination of liver enzymology in patients suffering from liver diseases. Methods Serum values of NAG, AFU, LAP, ASTm, GLDH, ADA, AST, ALT, ALP, GGT, 5' –NT and CHE were determined with auto-biochemical analyzer and analyzed statistically in 308 hepatitis patients and 115 healthy subjects. Results In acute hepatitis patients,the mean values of NAG, AFU, LAP, ASTm, GLDH, ADA, AST, ALT, ALP,GGT and 5' –NT increased significantly compared with those of healthy subjects, AUCs of ALT,LAP, AFU, ASTm,AST and ALP were 0.875, 0.861, 0.853, 0.830, 0.825 and 0.725 respectively, and positive rates of ALT, LAP, AFU, ASTm, AST and ALP were 100%, 93.8%, 78.1%, 87.5%, 100% and 68.8% respectively. In liver cirrhosis patients, the mean values of NAG, LAP, ASTm, GLDH, ADA, AST, ALP, GGT and 5' –NT increased significantly while thatof CHE decreased significantly compared with those of healthy subjects, AUCs of ADA, AST, 5' –NT, GGT and CHE were 0.764, 0.761, 0.752, 0.748 and 0.721 respectively, and positive ratesof ADA, AST, 5' –NT, GGT and CHE were 91.2%, 73.5%, 67.6%, 75.0% and 61.8% respectively. In severe hepatitis patients, the mean values of NAG, AFU, ASTm, GLDH, ADA, AST, ALT, ALP, GGT and 5' –NT increased significantly while that of CHE decreased significantly compared with those of healthy subjects, AUCs of AST, ALT, ASTm, CHE, AFU and GLDH were 0.876, 0.840, 0.792, 0.792, 0.751 and 0.729 respectively, and positive rates of AST, ALT, ASTm, CHE, AFU and GLDH were 100%, 100%, 93.6%, 100%, 72.3% and 91.5% respectively. In hepatocellular carcinoma, the mean values of NAG, AFU, LAP, ASTm, GLDH, ADA, AST, ALP, GGT and 5' –NT increased significantly while that of CHE decreased significantly compared with those of healthy subjects, AUCs of AFU,5' -NT, GGT, ALP and LAP were 0.822, 0.814, 0.811, 0.795 and 0.713 respectively, and positive rates of AFU, 5' –NT, GGT, ALP and LAP were 88.1%, 85.7%, 97.6%, 95.2% and 69.0% respectively. Conclusion ALT, LAP, AFU, ASTm, AST and ALP are valuable markers for diagnosing of acute hepatitis, ADA, AST, 5' –NT, GGT and CHE are valuable marker for diagnosing of liver cirrhosis, AST, ALT, ASTm, CHE, AFU and GLDH are valuable marker for diagnosing of severe hepatitis, and AFU,5' –NT, GGT, ALP and LAP are valuable markers for diagnosing of hepatocellular carcinoma. All items are less valuable for diagnosing of chronic hepatitis and alcoholic hepatitis.