AST ALTHeart 7800 450
Liver 7100 2850
Sk-muscle 5000 300
Kidneys 4500 1200
Pancrease 1400 130
Spleen 700 80
Lungs 500 45
RBC 15 7
serum 1 1
CPK
• Mg coenzyme
• Inhibitors: Ca, Zn, Cu, Mn, iodoacetate
• Activators: N-acetylcysteine
• CK-MB- α2 glubolin
CK
Ck activity Ck3-MM %
Ck2-MB %
Ck1- BB %
SK-muscle
2500 98.9 1.1 0.06
brain 555 0 2.7 97.3
heart 473 78.7 20 1.3
liver ~ 1 0 0 100
Aldolase
• ALD A : FDP• ALD B : F1P• ALD C : ?• Disease of Skeletal muscle 10-50 times• Duchenne disease • Myasthenia gravis & MS • In MI 5-8 times• Pattern parallel AST• Injection of cortisone & ACTH 10-18 times
LDH
• pH optimum in L P = 8.8-9.8
• pH optimum in P L = 7.8
• Inhibitors: reagents against thiol (Hg), Borate & Oxalate, EDTA
• HBDH = LD1
ALP
• Isoenzyme: liver, bonebone, intestinal, placental, renal
• Activators: Mg, Co, Mn• Inhibotors: phosphate, borate, oxalate, cyanide• 56º & 65º• Urea inhibition• Phe inhibited intestinal & placental•
5‘-Nucleotidase (NTP)
• Localized in cytoplasmic cell membrane
• pH optimum = 6.6 – 7• In hepatobiliary disease increased 2-6 times
• increase: stone, tumor, biliary cirrhosis• In early hepatitis NTP normal or slightly elevated• In hepatobiliary disease ALP & NTP elevated similarly
Comparison of ALP & NTP
• In hepatobiliary disease ALP & NTP elevated similarly
• In Skeletal disease, late pregnancy, childhood ALP increased & NTP normal
Gamma-glutamyl transferase (GGT)
• GGT present in all cells except muscle
• Small in cytosol & large fraction in cell membrane
• GGT elevated in all liver disease
• GGT more sensitive than ALP, NTP, LAP, GOT, GPT in obstructive jaundice
• Normal: skeletal disease, children older than 1 y, pregnancy
Comparison of GGT, ALP & NTP
ALP NTP GGT
Biliary tract disease
4.0 6.2 11.9
Acute & chronic hepatitis
1.5 1.1 2.3
Amylase
• Amylase hydrolased α-1,4 linkage
• Types of amylase:– Beta: plant & bacterial. Terminal reducing,
splits a maltose at a time– Alpha: animal & human. Random hydrolased
α-1,4 linkage
Human amylase
• pH optimum = 6.9 – 7
• Q10 =1.6 , up to 50° active
• Calcium metalloenzyme
• Activator ions: chloride, bromide, nitrate, phosphate
• MW= 55000 – 60000
• Electrophoresis: β & γ globulins
Types of human amylase
• P – type & S – Type (ptyalin)
• Macroamylase : usually S-type with IgA, IgG or other normal proteins
Causes of hyperamylasemia
• Pancreatic disease (P)
• Renal insufficiently (mixed)
• Mumps (s)
• Diabetic ketoacidosis (M)
• Acute alcoholism (M)
• Medicinal opiates (p)
• Heroin lung (s)
Amylase/creatinine clearance ratio (ACCR)
• ACCR (%) = (urine clearance of amylase/ urine clearance of creatinine) X 100
• ( urine amylase (U/L) X serum creatinine (mg/L) / serum amylase (U/L) X urine creatinine (mg/L) X 100
• Normal ACCR = 2 – 5 %• Acute pancreatitis > 8%• Macroamylasemia < 2%
Lipase
• Glycoprotein
• MW = 54000
• Concentration lipase in pancreas ~ 20000 serum
• alpha position carbons
• Lipase activated by NaCl
Cholinesterase
• Choline esterase I = true cholinesterase– RBC, lung, spleen, nerve endings, gray matter of the
brain
• Choline esterase II = pseudocholinesterase– Serum, Liver, pancreas, heart, white matter of the
brain
Cholinesterase
• Liver function
• Insecticide poisoning
• Normal range – 4000-12000 U/L– Level at birth = ¼ adults– In 2 month = adults
Cholinesterase
• 30-50% decrease– Acute & chronic hepatitis
• 50-70% decrease– Advanced cirrhosis & carcinoma
• Decrease slightly in pregnancy
Acid phosphatase
آنها مهمترین که دارد زیادی های ایزوآنزیماست پروستاتیک .ایزوآنزیم
پروستات بدخیم و خیم خوش اختالالت تشخیص دردارد .نقش
است تارتارات به حساس پروستاتیک .ایزوآنزیمفعالیت کاهش سبب یخچال در حتی سرم نگهداری
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