Abstract: Objective To observe the relationship between serum lactate dehydrogenase (LDH), 5′-nucleotide (5′-NT), and aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratios and the function of hepatic reserve and consolidated ascites in viral hepatitis-related cirrhotic patients. Methods One hundred cirrhotic patients with viral hepatitis admitted from June 2020 to June 2023 were selected, including 40 cases complicated with ascites (ascites group) and 60 cases without ascites (non-ascites group). Serum LDH, 5′-NT, AST, and ALT were measured at the time of admission, and the AST/ALT ratio was calculated. Serum LDH, 5′-NT, AST, ALT levels and AST/ALT ratios were compared between patients with different hepatic function classifications (Child-Pugh classification: 39 cases of class A, 37 cases of class B, 24 cases of class C) and in different groups. The relationship between serum LDH, 5′-NT, and the AST/ALT ratio and the hepatic reserve function of patients with viral hepatitis-related cirrhosis was analyzed by Spearman′s correlation coefficient analysis, and the relationship between serum LDH, 5′-NT, and AST/ALT ratio and the combined ascites was analyzed by logistic regression analysis. Results Serum LDH (317.79±35.56) IU/L, 5′-NT (19.36±2.15) U/L, AST (174.06±18.38) U/L, ALT (140.43±16.62) U/L, and AST/ALT ratio (1.24±0.15) were higher in patients with grade C than those of (298.41± (32.27) IU/L, (15.69±2.01) U/L, (138.41±15.05) U/L, (120.84±14.49) U/L, (1.15±0.12) in grade B patients and (280.25±30.14) IU/L, (11.14±1.53) U/L, (100.15±13.39) U/L, (92.12±11.23) U/L, (1.09±0.10) in grade A patients. The values in grade B patients was higher than those of grade A patients (F=10.211, 149.576, 178.196, 96.344, 11.457, P<0.05). Serum LDH (313.97±32.25) IU/L, 5′-NT (18.89±2.11) U/L, AST (168.32±18.85) U/L, ALT (130.25±15.56) U/L, and AST/ALT ratio (1.29±0.15) in the combined ascites group were higher than those of (283.98± (29.67) IU/L, (12.07±1.56) U/L, (107.86±12.27) U/L, (103.74±12.29) U/L, and (1.04±0.13) in the non-ascites group (t=4.782, 18.571, 19.444, 42.782, and 8.855, P<0.05). Spearman′s correlation analysis showed that serum LDH, 5′-NT and AST/ALT ratio were all positively correlated with the patients′ hepatic reserve function (r=0.415, 0.657, 0.632, P<0.05). Logistic regression analysis showed that serum LDH, 5′-NT and AST/ALT ratio might be the patients with cirrhosis of viral hepatitis with risk factors for concurrent ascites (OR=3.369, 2.748, 1.425, P<0.05). Conclusion Serum LDH, 5′-NT and AST/ALT ratio are strongly associated with liver reserve function and the occurrence of ascites in viral hepatitis-related cirrhotic patients.

Key words: Viral hepatitis, Cirrhosis, Liver reserve function, Ascites, Lactate dehydrogenase, 5′-Nucleotide, Aspartate aminotransferase/alanine aminotransferase