JS Wang, ZL Wang, XH Wang, QR Zhu, S Zheng

Abstract

Background and Aim: The significance of serum gamma glutamyltransferase activity and its dynamics have not been well investigated in Asian patients with idiopathic neonatal hepatitis. This study aimed to explore the significance in Mainland China. Methods: A retrospective analysis was performed in 38 cases with a diagnosis of idiopathic neonatal hepatitis. Their prognosis was compared between low or high gamma glutamyltransferase groups, and the mechanics of biochemical parameters were analysed. Results: Poor prognosis was found in 5 out of 6 patients with low gamma glutamyltransferase, compared to 3 out of 32 patients with high gamma glutamyltransferase (P=0.001). Dynamic analysis found that serum gamma glutamyltransferase levels gradually rose to a peak and then normalised along with a remission of jaundice in patients with good prognosis. However, the serum gamma glutamyltransferase level was consistently low in spite of the fluctuations of bilirubin and aminotransferases level in 5 cases with poor prognosis. The gamma glutamyltransferase level was high at presentation and then decreased along with their clinical deterioration in the other 3 cases with poor prognosis. Conclusions: Gamma glutamyltransferase can be used as a prognostic parameter in Chinese infants with intrahepatic cholestasis. Serum gamma glutamyltransferase being consistently low or decreased along with jaundice persistence or deterioration predicts poor prognosis.

背景和目的：在亞洲區一直未見有就血清 γ 谷氨酰基轉肽酶（GGT）的活性和動態的特性，對原因不明新生兒肝炎患者進行詳細的探討，本研究旨在探索中國兒童的有關特異性。方法：回顧性地分析了 38 項原因不明新生兒肝炎個案，他們的預後以高低 GGT 水平分組比較，並對生化指標機理進行分析。結果：6 名 GGT 水平正常的患者中 5 人預後差，對比 32 名 GGT 水平高的患者中只有 3 人（P=0.001）。動態分析顯示預後佳的患者其 GGT 水平逐漸上升至峰值，隨後回到正常水平伴黃疸復發。但是在 5 項預後差的個案中儘管膽紅素和轉氨酶水平波幅大，GGT 水平卻保持穩定。在另外 3 項預後差的個案中，發病時 GGT 上升，隨著臨床情況轉差時正常化。結論：GGT 在患有肝內膽汁淤積症的中國新生兒可作為預後指標，血清 GGT 持續正常或正常化伴持續性黃疸表示預後差。