血清トランスアミナーゼ活性値の臨床的意義に関する研究 第2編 肝炎および肝硬変症にみられる血清トランスアミナーゼ活性値の変動に及ぼす副腎皮質ホルモンの影響について

Effects of corticosteroids on the alterations of serum GOT and GPT activities were studied on patients with hepatitis and cirrhosis of the liver. 1. After the corticosteroid therapy, serum GOT and GPT activities were not elevated in 60.0% of the cases of acute hepatitis. On the other hand, in chronic hepatitis with inflammation at the portal triads, precirrhosis and cirrhosis of the liver, the percentage of the cases showing the activity elevation was 88.4%, 75.0% and 68.0%, respectively. Almost all cases of chronic hepatitis, in which degeneration of the liver cells or scar in the portal triads was the principal histological changes, showed no elevation of serum GOT and GPT activities during or after the corticosteroid treatment. 2. The time of the maximum elevation of serum GOT and GPT activities after the corti-costeroid therapy was the earliest in acute hepatitis, later in chronic hepatits and the latest in cirrhosis of the liver. 3. There was some relationship between the elevation of serum GOT, GPT activities and subjective symptoms of patients. The activity elevation had the closest relationship with jaundice in cirrhosis of the liver. 4. After the corticosteroid therapy, a single-peak rise of serum GOT and GPT activities was observed in acute hepatitis, while the cases of chronic hepatitis with inflammation at the portal triads often showed a fluctuation of the activities. The cases of chronic hepatitis, in which degeneration of the liver cells or scar in the portal triads was the principal histological changes, exhibited no elevation of the serum GOT and GPT activities after the treatment. In cirrhosis of the liver, several cases with constant values of serum GOT and GPT activities before the corticosteroid therapy exhibited a single-peak elevation or a fluctuation of the activities after the treatment. The altered values, moreover, did not easily decrease to the normal levels. 5. Catabolic hormone of protein, used in addition to corticosteroids, could not preclude the elevation of serum GOT and GPT activities. 6. In patients without hepatic diseases, corticosteroids did not appear to modify the serum GOT and GPT activities. 7. The GOT and GPT activities in the tissue homogenates of the liver were lowered when the activities in serum were elevated after the corticosteroid therapy. 8. In the cases where the activity elevation was observed at the earlier stage after the commen ement of the corticosteroid therapy, the inflammatory changes of the liver were stronger than in those with the later elevation of serum GOT and GPT activities. 9. Therefore, it may be reasonable to infer that there is a close relationship between a factor or factors of the chronification of hepatitis and the effects of corticosteroids on serum GOT and GPT activities. 10. Differences of the compounds of corticosteroids did not produce any significant changes in the effects on serum GOT and GPT activities.