The clinical significance of liver mitochondrial enzyme determinations in the serum for the diagnosis of drug induced liver injury.
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概要
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The activities of serum glutamate dehydrogenase (GDH), ornithine carbamyl transferase (OCT) and mitochondrial GOT (m-GOT), which are liver mitochondrial enzymes with different sublobular localization, were determined simultaneously in patients with drug induced liver injury and acute viral hepatitis to elucidate the usefulness of the determinations of these enzymes in the diagnosis of drug induced liver injury. Serum GDH activity was higher in drug induced liver injury than in acute type A hepatitis, and conversely, serum OCT activity was lower. Serum m-GOT levels were significantly lower in drug induced liver injury than in various types of viral hepatitis. The ratios of m-GOT to cytosolic GOT, however, were significantly higher in drug induced liver injury than in various types of viral hepatitis. In almost all cases in drug induced liver injury, the ratios of GDH/OCT were high and the values were nearly 1.0. In acute viral hepatitis, only 3 cases of NANB hepatitis showed higher ratios over 1.0. These results suggest that GDH/OCT ratios accurately reflect the sublobular distribution of hepatocellular damage, and that the determination of GDH/OCT ratios is a useful parameter in the diagnosis of drug induced liver injury.
- 財団法人 日本消化器病学会の論文