Abnormally elevated transaminases

Introduction Transaminase is an indicator of liver function and is often used during medical examinations. Transaminase is an indispensable "catalyst" in the body's metabolic process and is mainly found in hepatocytes. When hepatocytes develop inflammation, necrosis, poisoning, etc., causing damage to the liver cells, the transaminase is released into the blood, causing the serum transaminase to rise. Transaminase levels between 0 and 40 are normal. An increase in transaminase only indicates that the liver may have been damaged. In addition to hepatitis, many other diseases can cause an increase in transaminase.

Cause

An increase in transaminase only indicates that the liver may have been damaged. In addition to hepatitis, many other diseases can cause an increase in transaminase. First, many tissues in the human body contain transaminase. For example, myocarditis and myocardial infarction may increase aspartate aminotransferase. Secondly, if there are biliary obstructive diseases such as gallstones, the level of transaminase in the blood may increase due to cholestatic. In addition, for some people who seem to have no serious illness, it is also possible that alcoholic liver is caused by long-term alcoholism, or fatty liver is caused by unreasonable diet structure, resulting in high transaminase. Tiredness may also increase transaminase levels.

an examination

Related inspection

Liver function test liver and gallbladder imaging liver and gallbladder percussion

Generally, the transaminase mainly examined in the physical examination includes alanine aminotransferase (ALT, commonly known as alanine aminotransferase) and aspartate aminotransferase (AST, commonly known as aspartate aminotransferase), of which the former (ALT) is most commonly used. 1% of liver cell damage can double the concentration of ALT in the blood. Therefore, ALT levels can be more sensitive to detect whether the liver is damaged.

Differential diagnosis

Transaminase is an indicator of liver function and is often used during medical examinations. Transaminase is an indispensable "catalyst" in the body's metabolic process and is mainly found in hepatocytes. When hepatocytes develop inflammation, necrosis, poisoning, etc., causing damage to the liver cells, the transaminase is released into the blood, causing the serum transaminase to rise. Transaminase levels between 0 and 40 are normal.

There are many aminotransferases in the human body. There are two kinds of transaminase that are clinically tested for liver function by blood tests. One is called alanine aminotransferase (ALT); the other is called aspartate aminotransferase (AST). ALT and AST are mainly found in hepatocytes, and other organs such as kidney, heart muscle, pancreas, muscle, spleen, gall bladder, and lung also contain a certain amount of ALT and AST. ALT is mainly present in the cytoplasm, and AST is mainly present in the mitochondria of the cytoplasm. When cells are damaged (such as hepatitis, myocarditis, pancreatitis, etc.), ALT first enters the bloodstream. When the cells are severely damaged and endanger the mitochondria, AST also enters the bloodstream. In addition, malnutrition, alcohol abuse, the use of certain drugs, fever, etc. can cause a slight increase in transaminase. Under physiological conditions, serum transaminase also has variations, such as severe activity, physical exercise, menstrual period, transaminase can also temporarily increase.

Since ALT and AST are mainly present in hepatocytes, liver damage is often indicated when it is significantly elevated. Of course, there are many causes of liver damage, such as liver trauma, acute and chronic inflammation of various livers, fatty liver, cirrhosis, and liver cancer. Therefore, when you find that the transaminase is elevated, don't panic, or take it lightly. You should further investigate the cause.

It is generally believed that if the serum value of ALT exceeds the upper limit of 2-3 times and lasts for more than two weeks, it indicates that there may be cases of hepatobiliary disease that may exclude alcoholism, myocarditis, chemical poisoning, parasitic diseases, etc.; if the measured value exceeds the upper limit of normal 20 times, indicating the presence of hepatobiliary disease; at this time, if accompanied by a positive hepatitis virus marker, hepatitis can be diagnosed. The normal upper limit of ALT is 40 units, 2.5 times is 100 units, and 20 times is 800 units.

In acute hepatitis, the increase in ALT is large, more than 500 units, and even more than 1000 units, and sometimes AST is also significantly increased. Regardless of acute hepatitis, chronic hepatitis or even cirrhosis, if the increase in AST is equal to or greater than ALT, ie AST/ALT 1, it often indicates that hepatocyte injury is severe and the condition is relatively heavy. The increase of ALT in chronic hepatitis is not large, and it is more than 300 units.

Generally, the transaminase mainly examined in the physical examination includes alanine aminotransferase (ALT, commonly known as alanine aminotransferase) and aspartate aminotransferase (AST, commonly known as aspartate aminotransferase), of which the former (ALT) is most commonly used. 1% of liver cell damage can double the concentration of ALT in the blood. Therefore, ALT levels can be more sensitive to detect whether the liver is damaged.

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