دراسة قيمة التشخيصية لنسبة الأنزيمات الكبدية الناقلة للأمينال ALT/AST في تشخيص التشمع الكبدي

الموضوعات

طب

روابط وملفات

التعريف والنوع

رقم الوثيقة

05fcf31a-67cd-4f5d-886d-a66baccd2b42

رقم العقد

0

نوع الوسائط

Crawler

نوع المحتوى

الرسائل العلمية

صيغة المصدر

رسائل ماجيستير

نوع الملف

pdf text

أسماء الملفات

1967799_1.pdf

بيانات النشر

ترجمة العنوان

Study of the Diagnostic Utility of Amino-Transferases (ALT/AST) Ratio in the Diagnosis of Liver Cirrhosis

ألقاب المؤلفين

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اللغة

Arabic

المصدر والدورية

اسم المصدر

دراسة قيمة التشخيصية لنسبة الأنزيمات الكبدية الناقلة للأمينال ALT/AST في تشخيص التشمع الكبدي

المحتوى والصفحات

عدد الصفحات

0

ترجمة الملخص

Detection of cirrhosis in patients of chronic liver disease is very important from therapeutic point of view. The gold standard for detection of hepatic cirrhosis is liver biopsy. Also ultrasonography of abdomen can be equally good in hands of a good ultrason logist .Ratio reversal means that in normal individuals ALT is more than AST and thus ALT/AST> 1 but with development of cirrhosis AST becomes > ALT and so AST/ALT>1 or ALT/AST<1.The prothrombin time (PT) has a normal range of 10-14 seconds in normal healthy individuals and is prolonged in patients of chronic liver disease. Both ALT/AST ratio reversal (AST/ALT>1) and prolonged prothrombin time are separately related to hepatic cirrhosis. The aims and objectives of this study are to utilize these two investigations beyond their own exact values and to emphasize their importance to avoid hepatic biopsy in patients of CLD to detect cirrhosis. Subjects: The total number of cases were (100) divided in two equal groups: first; patients having cirrhosis due to hepatitis B and/ C (study group). The other group comprised of those patients who had hepatitis B and/C but had no radiological or clinical evidence of cirrhosis (control) group). Results: It was found that the reversal of ratio alone is 86% specific as an indicator of hepatic cirrhosis and almost 70% sensitive and have a positive predictive value of 90%. The statistical significance test based on z-test for difference of proportion yields with a p value=0.0074. On the other hand, the prolonged PT and ratio reversal are 96% Specific and 88% sensitive with a positive predictive value of 97.6%. Z-test for difference of proportion yields here with a p value=0.0001.CONCLUSIONReversal of ALT/AST ratio alone has a high sensitivity and high positive predictive value (approximately 90%) and with prolonged PT has a higher specificity and higher positive predictive value (approximately 98%).This study concluded that the ALT/AST ratio could be used in the right position within the workup of patients with CLD. Diagnostically it may help the clinician assess patients who cannot or do not want to under goliver biopsy.

إشراف وإعداد

الإشراف

لؤي شاكردي, محمود ناصر

الإعداد

فريد فاخوري

الاقتباسات الببليوغرافية