Atanasova, A.

Gancheva, D.

Kamburova, D.

Shalev, I.

Zhechev, V.

English

Varna Medical University Press: Journals

cripta Scientifica Medica, vol.28, Suppl.1,pp,53-54 Copyright © Medical University, Varna, 1991 C H A N G E S IN T H E A C T I V I T Y O F S O M E S E R U M E N Z Y M E S IN C H R O N I C L I V E R D I S E A S E S I. S h a l e v , A . A t a n a s o v a , D. G a n c h e v a , V . Z h e c h e v , D. K a m b u r o v a Clinic of Gastroenterology, Varna In fatty liver (FL) a moderate increase in GGT, AP, LAP activity is established and especially in cases with alcoholic etiology of FL the activity of GGT is significantly higher. The patients with chronic per­sistent hepatitis (CPH) have normal or slightly increased activity of GGT, AP, LAP as well as serum transaminase activity, particularly ALAT. The increased GGT activity is an early and often the only patho­logical index. A significantly higher activity of all the enzymes is estab­lished in patients with chronic active hepatis (САН) and this activity is higher than that of patients with already formed liver cirrhosis (LC). As a rule, in patients with LC GGT activity is higher especially in chronic alcoholics where it is higher than that in patients with chronic alco­holic hepatitis.Our study includes 65 patients with FL, 83 with CPH, 53 with CAN, 349 with LC and 45 healthy controls. About 90% of the patients are chronic alcoholics. The activity of serum enzymes is deter­mined by routine clinical laboratory methods. The diagnosis is con­firmed by morphological studies and/or with laparoscopy. The highest activity of all the measured enzymes was found in the patients with САН in comparison with the other groups (table 1) and the differences are statistically significant for serum transaminases and insignificant for GGT and AP. This is connected with morphologically established activity of the pathological process in these patients and our results comply with the experience of other authors, too. Table 1 . Activity of some serum enzymes (U/1) in patients with FL, CPH, САН, LC and healthy controls Disease ASAT ALAT GGT AP x T x FL 45 50 120 143 CPH 93 122 302 193 САН 258 402 301 265 LC 110 73 228 257 Controls 10 10 15 32 54 The statistically significant higher ALAT activity in comparison with that of ASAT in patients with САН is also of importance. The in­creased activity of serum enzymes resembles that of acute viral and toxic hepatitis and leads to a differential diagnosis predominanty with them and less with chronic liver diseases - FL, CPH and even an already formed L C . In contrast to many other authors we find ASAT/ALAT index greater than 1 only in patients with LC and in the other patients it is less than 1. Our results are similar as far as the GGT/AP index is concerned, in comparison with healthy controls, a statistically signifi­cant increase of investigated enzyme activity was established in pa­tients with FL and CPH. The change in GGT activity is considerably greater and it appears earlier and in almost all patients. Many other authors report similar data. A statistically significant higher activity of the investigated enzymes was found in the patients with L C in compari­son with the healthy controls. The most significant and constant is the increase of GGT activity and this together with the ASAT/ALAT index more than 1 refers to an alcoholic etiology of the disease. In patients with already formed LC enzyme activity is lower than in those with САН, initial or developing L C . Our observations comply with the data of other authors. The lowest enzyme activity was found in the patients with FL as compared with those with CPH, САН and LC and all the dif­ferences were statistically significant. When comparing the enzyme ac­tivity in patients with CPH, САН, and LC the highest activity was found in those with САН. The greatest difference is in transaminase activity. This is to confirm the assumption that the activity of the pathologic process in the liver and the attendant cytolysis induce the activity of cytolytic enzymes - ASAT and ALAT. The difference between the serum transaminases in patients with САН and LC is statistically significant. The activity is higher in patients with САН. There is an increase in enzyme activity in chronic liver diseases and it correlates with the severity and activity of the pathologic pro­cess in the liver. In patients with САН the enzyme activity is the hig­hest and comes close to that in acute viral and toxic hepatitis. The increase in ASAT and especially ALAT activity is more significant while that of GGT and AP is more moderate but very frequent. The evaluation of serum enzyme activity may have a great significance for the diag­nosis and prognosis of chronic liver diseases. 

CHANGES IN THE ACTIVITY OF SOME SERUM ENZYMES IN CHRONI CLIVER DISEASES

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CHANGES IN THE ACTIVITY OF SOME SERUM ENZYMES IN CHRONI CLIVER DISEASES

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