Clinical significance of serum .GAMMA.-glutamyl transpeptidase in patients with acute hepatic failure.

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To evaluate the association between serum γ-glutamyl transpeptidase (GGT) and liver regeneration and prognosis of acute hepatic failure (AHF), we examined the sequential changes of serum GGT in 53 patients with fulminant and subacute hepatitis (FH and SAH). The serum GGT levels on admission were significantly decreased in patients with acute and subacute type of FH and SAH, as compared with ordinary acute hepatitis (AHo) (102±108, 60±43 and 53±43IU/l vs 274±145IU/l, all p<0.001). Repeated determinations of serum GGT showed prominent increases in all 6 surviving cases with FH. On the other hand, very low levels of serum GGT persisted in all patients with fatal outcomes. 3 of 6 surviving patients in the high serum GGT group had simultaneously increased serum alkaline phosphatase levels, while there were no changes in other 3 patients. Furthermore, maximum elevation of serum GGT levels were observed in ultimate relation to increases of serum α-fetoprotein levels. Analysis of GGT isoenzyme by using polyacrylamide gradient gel electrophoresis and gel filtration showed that the high serum GGT in surviving patients with FH could be associated with the states of liver regeneration and intrahepatic cholestasis after hepatic massive necrosis.<BR>Experimentally, the activity of GGT in D-Galactosamine hepatitis rat liver increases in parallel to the increase of DNA synthesis of the liver.<BR>These results suggested that the serum GGT was a useful indicator for functioning liver mass, liver regeneration and prediction of prognosis in AHF and that GGT could be attributed to liver regeneration after massive necrosis of hepatocyte.
社団法人日本肝臓学会の論文

Clinical significance of serum .GAMMA.-glutamyl transpeptidase in patients with acute hepatic failure.

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