Xet nghiem gan cao o nguoi uong ruou – co the co y nghia gi

Ket qua xet nghiem mau voi cac enzyme gan tang cao o nguoi uong ruou la mot trong nhung ly do pho bien nhat de duoc chuyen den bac si chuyen khoa gan. Tuy nhien viec giai thich nhung ket qua nay phuc tap va can xem xet nhieu yeu to – khong chi ban than cac con so. Enzyme nao tang cao bao nhieu chung lien he voi nhau nhu the nao cac thong so khac nao di kem su tang cao va bieu hien lam sang cua benh nhan la gi – tat ca cung nhau xac dinh cac ket qua thuc su co y nghia gi va can phai lam gi tiep theo.

Enzyme gan – chung do gi va khong do gi

Thuat ngu “xet nghiem chuc nang gan” thuc su khong chinh xac. AST, ALT va GGT khong do chuc nang gan – chung do ton thuong te bao gan hoac kich hoat enzyme. Danh gia chuc nang gan that su dua tren cac thong so khac: albumin, INR, bilirubin.

GGT – dau hieu nhay cam nhat cua viec lam dung ruou

Gamma-glutamyltransferase (GGT) la dau hieu xet nghiem nhay cam nhat cua viec lam dung ruou – tang o 70-80% nguoi uong man tinh truoc khi xuat hien bat ky trieu chung lam sang nao. Han che quan trong: GGT khong dac hieu. No cung tang voi nhieu thuoc roi loan tuyen giap beo phi va benh tuy. Sau khi ngung uong ruou GGT binh thuong hoa trong 4-8 tuan.

AST va ALT – enzyme ton thuong te bao gan

Trong benh gan do ruou gia tri AST va ALT hiem khi vuot qua 300-400 IU/l. Aminotransferase rat cao (tren 1000 IU/l) trong benh ruou goi y co nguyen nhan dong thoi khac.

Chi so De Ritis – ti le AST/ALT

O nhung nguoi lam dung ruou xay ra tinh trang thieu hut pyridoxal-5-phosphate chon loc lam giam hoat tinh ALT. Ket qua la ti le AST/ALT tren 2 – dac trung cho ton thuong gan do ruou voi do nhay khoang 70% va do dac hieu khoang 80%.

Cau hoi thuong gap

Tai lieu tham khao

1. Cohen JA, Kaplan MM. The SGOT/SGPT ratio – an indicator of alcoholic liver disease. Dig Dis Sci. 1979;24(11):835-838.
2. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Alcohol-related liver disease. J Hepatol. 2018;69(1):154-181.
3. Crabb DW, et al. Diagnosis and Treatment of Alcohol-Associated Liver Diseases: 2019 Practice Guidance. Hepatology. 2020;71(1):306-333.