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각종 간질환에 (肝疾患) 있어서 r - GTP 와 SGOT , SGPT 의 활성에 관한 연구
A Study of SGOT , SGPT and r - GTP Activity in Various Hepatic Diseases각종 간질환에 (肝疾患) 있어서 r - GTP 와 SGOT , SGPT 의 활성에 관한 연구
김세종(Sei Jong Kim),유종선(Jong Sun Rew),양동희(Dong Hi Yang),장건성(Kun Sung Jang),박종춘(Jong Chun Park),이태희(Tae Hi Lee)
UCI I410-ECN-0102-2009-510-004939643

Of the many hepatic enzymes, only a few are generally used for diagnosis of liver disease. Alkaline phosphatase and aminotransferases are example of two differnet groups of enzymes providing information about pathologic conditions. Aminotransferase reflects hepatic cellular injury with sorbital dehydrogenase and 5-lactic dehydrogenase. Alkaline phosphatase refrects cholestasis and its activity can easily be corrected with that of other enzymes like leucine- aminopepeptidase and 5-nucleotidase. Enzymes indicating alterations of the liver, but not belonging to one of those groups mentioned, include gamma-glutamyl transpeptidase(r-GTP), which was introduced as a test of liver function by Polish authors to indicate chronic hepatitis. A special feature of this enzyme is its increasement with prolonged intake of some drugs or alcohol. This enzyme has been used for differentiating viral hepatitis from obstructive jaundice mainly correlating SGOT or SGPT with r-GTP. Later, r-GTP was not only recommended as an indicator of minor alterations of the liver but also it was introduced as a most sensitive test for alcoholic hepatic cellular injury. The SGOT/SGPT ratio is used as an indicator of minor viral hepatitis and alcoholic induced liver injury. It should be due to the different location in the hepatocyte of the enzyme, as SGPT is present free at cytosol, whereas SGOT is demonstrable at mitochondria and cytosol in hepatocyte. r-GTP in the liver is found in hepatocyte and small bile ductules. The enzyme can be detect by enzyme histochemical methods in hepatocyte and by cytochemical techniques bound to membranes and microsomes. So the observations of SGOT/SGPT, SGOT/r-GTP and r-GTP/SGPT in various hepatic diseases concurrently might be helpful for making the differential diagnosis of the hepatic diseases. So we have observed the ratios of the enzyme activities, SGOT/SGPT, SGOT/r-GTP and r-GTP/SGPT in 20 cases of control group and 130 cases of various hepatic diseases group (Male 107, Female 42), which is including 25 cases of acute viral hepatitis(A.V.H.: Male )9, Female 8 ), 17 cases of chronic active hepatitis(C.A.H.: Male 9, Female 8.), )14cases of chronic persistent hepatitis(C.P.H.: Male 10, Female 4), 14 cases of liver cirrhosis(Male 34, Female 6), 20 cases of primary hepatocellular carcinoma(Male 16, Female 4. ), 8 cases of liver abscess(Male 4, Female 4,) and 12 cases of gall stone(Male 5, Female,7) The results were as follows: 1) In normal control group, the SGOT/SGPT is l.76+- 0.44, SGOT/r-GTP 1.20+-0.67 and r-GTP/SGPT 1, 931+-l. 14 The activity of alkaline phosphatase is 2.6+-0.6 Bessey-Lowry unit 2) In A.V.H. group, the SGOT/SGPT is 0. 78+-0.46, SGOT/r-GTP 3. 46+-2.36 and r-GTP/ SGPT 0.47+-0.91. The ratio af the SGOT/SGPT and r-GPT/SGPT are decreased significantly than the nor mal(p(0.005, p(0.005), but the SGOT/r-GTP is increased significantly, 2.5 times than the normal(p(0.005) It were helpful for differentiating A.V.H. for the other hepatic diseases 3) In C.A.H. group, the SGOT/SGPT is 0. 7+-0.35, SGOT/r-GPT is 1. 63+-1.23 and r-GTP/ SGPT is l.76+-1.38. The each ratio of SGOT/r-GTP and SGPT/SGPT is slightly increased and decreased than the normal(p=0.10, p<0.05) The SGOT/SGPT ratio was markedly decreased. It was helpful for the differentiation of the C.A.H. from the other hepatic diseases. In cirrhosis of liver group, the SGOT/SGPT is 2.05+0.88, SGOT/r-GTP is 1.27+-1.59 and r-GTP/SGPT is 2.97+-2.48. All of the ratios were increased slightly with mild elevation of the alkaline phosphatase activity. It svas also helpful for differential diagnosis of the liver diseases. 5) In primary hepatocellular carcinoma, The SGOT/SGPT is 1.82+-0.97, SGOT/r-GTP is 0.49+-0.29 and r-GTP/SGPT is 5.02+-3.80,The alkaline phosphatase activity was elevated over 2.5 times than the normal as 7.2+-5.2 Bessey-Lowry unit. With the marked elevation of r-GTP/SGPT ratio and alkaline phosphatase activity, the markedly decreased ratio of SGOT/r-GTP were

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