Elevated transaminases

Introduction Transaminase is an indicator of liver function and is often used during medical examinations. Many people do not understand, it is easy to misunderstand, thinking that as long as the transaminase is high, it is hepatitis. In fact, transaminase only reflects the health of the liver. Transaminase is an indispensable "catalyst" in the body's metabolic process and is mainly found in hepatocytes. When hepatocytes undergo inflammation, necrosis, poisoning, etc., causing damage to the liver cells, the transaminase is released into the blood, causing the serum transaminase to rise.

Cause

Serum alanine aminotransferase (abbreviated as transaminase) is present in the mitochondria of hepatocytes. As long as the liver is damaged by inflammation, necrosis or poisoning, the transaminase is released into the blood by the liver cells. Increased transaminase is multifactorial, anger, depression, long-term over-consideration and insomnia, as well as unhealthy life, hunger and labor, malnutrition or sorghum, and lascivious, can cause abnormal liver function, resulting in a single transaminase increase.

an examination

Related inspection

Serum alanine aminotransferase liver function test liver palpation hepatobiliary imaging liver and gallbladder percussion

This change is of great significance for the diagnosis of acute hepatitis and the activity of chronic liver disease. The normal value is 40 units/liter. Due to different detection methods, the normal values of hospitals may vary. The activity of the enzyme may increase from hundreds to thousands of units, and the range of damage to liver cells may be certain. Relationship. Because the diagnosis of viral hepatitis has always been to detect ALT, and the increase in ALT is very important in the diagnosis of viral hepatitis, in addition, biliary tract disease, alcoholic liver damage, drug-induced liver damage, fatty liver, heart ALT can also be elevated in many diseases such as source liver damage involving the liver.

Transaminase normal reference value:

The normal value of aspartate aminotransferase ALT is 0-37u/L (all kinds of liver disease, early myocardial infarction, hepatocyte necrosis, liver cirrhosis, liver cancer are abnormally high).

The normal value of alanine aminotransferase AST is 0-40 u / L (hepatitis drug poisoning obstructive jaundice, hepatic degeneration cholangitis cholangiocarcinoma are abnormally high).

The normal value of the grain / gluten ratio is 1.5 to 2.5: 1 (when the ratio is less than 1, it is called inverted, which is one of the symptoms of chronic hepatitis or cirrhosis.

The normal value of -glutamyltranspeptidase -GT is 0-50 u/L (primary or metastatic liver cancer biliary tract infection cirrhosis, myocardial infarction are abnormally high).

The normal value of alkaline phosphatase AKP (ALP) is 15-112 u / L (obstructive jaundice, acute, chronic jaundice hepatitis, liver cancer are abnormally high).

Differential diagnosis

Differential diagnosis of elevated transaminase:

1, the liver itself, especially various types of viral hepatitis, cirrhosis, liver abscess, liver tuberculosis, liver cancer, fatty liver, sinusoid nucleus degeneration can cause different degrees of transaminase increased. In addition to the liver, other organs in the body such as heart, kidney, lung, brain, testis, and muscle also contain this enzyme. Therefore, when myocarditis, pyelonephritis, lobar pneumonia, tuberculosis, Japanese encephalitis, polymyositis, acute sepsis, typhoid fever, meningitis, malaria, cholecystitis, leptospirosis, influenza, measles, schistosomiasis, Increased blood transaminase was also observed in the squeezing syndrome.

2, because the transaminase is discharged from the bile duct, if there are bile duct, gallbladder and pancreatic diseases, bile duct obstruction, can also increase transaminase. Clinically common are cholecystitis, bile duct mites, hepatic bile duct stones, gallbladder and bile duct tumors, periampullary carcinoma, congenital biliary dilatation, acute and chronic pancreatitis, pancreatic head cancer and hemorrhagic necrotizing pancreatitis. Drug-induced or toxic liver damage, as well as drug allergies can cause elevated transaminase, often accompanied by cholestatic jaundice and liver cell damage. Clinically, it has been reported that the transaminase can be increased in 12 to 48 hours after administration, and the peak can be reached from 4 to 10 days. The timely withdrawal of the drug will return to normal within 3 weeks. Other medical diseases such as systemic lupus erythematosus, hyperthyroidism, diabetes, malignant reticulocyte disease, heart failure, rheumatic fever, peptic ulcer, acute and chronic gastroenteritis, and uremia may all have elevated transaminase. Normal pregnancy, pregnancy poisoning, acute fatty liver in pregnancy are also common causes of increased transaminase. In addition, after severe exercise, it can also cause an increase in transaminase.

After exercise, the lactic acid content increases and accumulates in the body. The lactic acid metabolism causes the body to be relatively hypoxic and hypoglycemia, resulting in increased permeation of the liver cell membrane and an increase in transaminase. This change is of great significance for the diagnosis of acute hepatitis and the activity of chronic liver disease. The normal value is 40 units/liter. Due to different detection methods, the normal values of hospitals may vary. The activity of the enzyme may increase from hundreds to thousands of units, and the range of damage to liver cells may be certain. Relationship. Because the diagnosis of viral hepatitis has always been to detect ALT, and the increase in ALT is very important in the diagnosis of viral hepatitis, in addition, biliary tract disease, alcoholic liver damage, drug-induced liver damage, fatty liver, heart ALT can also be elevated in many diseases such as source liver damage involving the liver.

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