RESUMO
To assess AST/ALT ratio in patients with liver disease, i.e. hepatitis and cirrhosis and to evaluate its significance as predictor of cirrhosis in our population. Place and Duration of Study: The study was carried out in the Department of Medicine and Gastroentero logy Medical Unit-I Post Graduate Medical Institute/Services Hospital, Lahore and Department of Pathology PGMI Lahore Pakistan. The period of study was from July 1999 to July 2000. Subject and This study comprised 75 patients suffering from liver disease. All the patients were thoroughly examined clinically and ultrasound was performed. They were divided into two groups; Group I: It included 50 [35 male, 15 female] patients with cirrhosis of the liver confirmed clinically and by ultrasonography. Group II: It comprised of 25 [18 male, 7 female] patients with acute hepatitis confirmed by serology. The blood sample were sent to department of pathology Postgraduate Medical Institutes Lahore. HBs Ag and anti-HCV were performed using the commercially available kits based on ELISA techniques. AST and ALT were determined using the kits based on photometric methods in which the Oxo-acids are assayed by coupling with 2-4 dinitrophenyl hydrazine. The mean AST and ALT concentrations of the patients with hepatitis [Group II] were elevated significantly [P<0.001] as compared to those of the cirrhotic patients [Group I]. In contrast, the mean AST/ALT ratios of the cirrhotic patients [Group I] were elevated significantly [P<0.001] than the patients with hepatitis. Conclusions: The present study shows that the mean AST/ALT ratios of the cirrhotic patients were significantly higher [P < 0.001] as compared to those with hepatitis. Hence, the AST/ALT ratio can be considered as a dependable marker of fibrosis in patients with chronic liver disease in Pakistan, even though liver biopsy remains the most definitive diagnostic measure for cirrhosis