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肾衰竭患者的血清酶

Authors
Neil S Sanghani, MD
Ramesh Soundararajan, MD, FACP
Thomas A Golper, MD
Section Editor
Jeffrey S Berns, MD
Deputy Editor
Alice M Sheridan, MD
Translators
路万虹, 副主任医师

引言

终末期肾病(end-stage renal disease, ESRD)患者的血清酶通常异常。这部分是由于肾脏排泄功能丧失和频繁出现的多种合并症。由于很多疾病的诊断是基于发现这些酶水平升高，缺乏关于各种疾病状态下不同酶血清浓度的知识就会阻碍我们对ESRD患者进行准确的临床评估。

本文将总结在透析患者中血清酶的应用和酶浓度变化的意义。有关肾衰竭患者中血清心肌酶的讨论参见其他专题。 (参见“肾衰竭患者的血清心脏生物标志物”)

肝酶

最常用于帮助评估肝胆系统疾病诊断的血清酶包括转氨酶、碱性磷酸酶和γ谷氨酰转肽酶(gammaglutamyl transpeptidase, GGT)。

转氨酶 — 常规测量血清天冬氨酸转氨酶和丙氨酸转氨酶[AST(SGOT)和ALT(SGPT)]浓度来评估伴或不伴肾衰竭患者的肝功能。正常情况下，转氨酶在循环中的浓度较低，通常小于40U/L。 (参见“肝生化和肝功能试验异常患者的评估”，关于‘肝酶’一节)

长期透析患者和慢性肾衰竭患者的血清转氨酶浓度都主要处于正常范围的低限[1-4]。尽管确切原因尚不清楚，但潜在的原因可能与吡哆醇缺乏症(磷酸吡哆醛是合成ALT和AST所必需的辅酶)[5-7]和/或尿毒症环境中存在抑制性物质有关[1]。

         

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Literature review current through: 2017-06 . | This topic last updated: 2016-01-15.
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