Serum γ-G. T. P. Activity in Biliary Diseases

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  • 胆道疾患におけるγ-Glutamyltranspeptidaseの臨床的意義に関して
  • タンドウ シッカン ニ オケル ガンマ-Glutamyltranspeptidase ノ リンショウテキ イギ ニ カンシテ

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The value of serum γ-G. T. P. in diagnosing the degree of obstruction in biliary diseases is studied.<br>Serum γ-G. T. P. activity was measured in 59 patients with biliary diseases. (Table 1) The site of obstruction was confirmed by the operation in 45 patients. Serum γ-G. T. P. was measured according to the modified Orlowski' s method using the γ-G. T, P. Kit (CS-346) by the SANKYO PRODUCTS. The mean value of in normal human subjects is 13.6±11.6 mu/ml.<br>When the stones are located in the gall bladder, common bile duct and sphincter of Oddi, the mean value of γ-G. T. P. is 104.1±122.1, 359.8±260.0 and 862.4±663.6 mu/ml respectively. Maximum level of serum γ-G. T. P. was found in patients with stones impacted at the sphincter of Oddi. The serum level of γ-G. T. P. is correlated with extrahepatic cholestasis. The degree of abnormalization is considered as index of extrahepatic obstruction.<br>The correlation of level of γ-G. T. P. with L. A. P. is higher than that with Al. Pase…(Table 3, 4) Elevated γ-G. T. P. cases with normal level of L. A. P. and Al. Pase. were found. In cases having impacted stones, level of γ-G. T. P. showed more than 20 times of the normal value, though Al. Pase. revealed 3 times and L. A. P. 2 times. All the cases but two returned to normal value after the relief of obstruction by surgery. The two cases showed elevated γ-G. T. P. than previous level. The wedge liver biopsy was performed in all cases. The above described two cases revealed the liver cirrhosis and cholestatic hepatitis respectively. From these findings serum γ-G. T. P. appears to reveal earlier stage of the liver damadge of which conventional liver function tests could not be detectable as yet.

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