Laboratory examination of hepatitis B mainly includes two aspects: 1, blood biochemical examination (liver function examination). 2. Detection of virus markers (five items of hepatitis B). The commonly used items of liver function examination mainly include total protein (TP), albumin (ALB) and globulin (GLO), which mainly reflect the synthetic function of the liver. Alanine aminotransferase and aspartate aminotransferase mainly reflect the damage of liver cells. Direct bilirubin and total bilirubin mainly reflect the metabolic function of hepatocytes. (Excerpt from: seeking medical advice network)
Five tests of hepatitis B
Is there hepatitis B virus in HBsAg?
Is surface antibody (anti-HBs) protective?
Is е antigen (HBeAg) virus replicable and contagious?
Is the replication of е antibody (anti-HBe) virus inhibited?
Has the core antibody (anti-HBc) ever been infected with hepatitis B virus?
With the development of technology, HBV-DNA detection can now reflect whether there is hepatitis B virus in the liver and whether it is replicating. This kind of test should be carried out in a big hospital, which can make the results more accurate.
Big sanyang and small sanyang
Dasanyang
Surface antigen (HBsAg)+
е antigen (HBeAg)+
Core antibody (anti-HBc)+
This situation usually reflects that virus replication is active.
Xiaosanyang
Surface antigen (HBsAg)+
е antibody (anti-HBe)+
Core antibody (anti-HBc)+
Patients with small three-yang diseases should be tested for DNA. If it is positive, it reflects the active replication of the virus. If it is negative, it reflects that the virus is suppressed and the virus replication is inactive.
It is wrong to think that more plus signs mean that you have hepatitis.
Etiological examination (two and a half examinations) only reflects whether the patient is infected with the virus and whether the virus replicates. As for the onset, it is necessary to determine whether he has liver disease, the severity of his illness and the damage of liver cells according to the results of liver function examination.
What abnormal liver function tests suggest hepatitis?
For example, the increase of transaminase indicates that liver cells are damaged, indicating that liver function is abnormal, that is, acute liver disease, which may be positive for chronic liver disease. The increase of bilirubin (jaundice) indicates that the liver function is in a state of destruction.
If there is no abnormality in liver function, will the virus affect the body?
The main mechanism of liver injury caused by hepatitis B virus infection is that it is easy to cause immune disorder. The direct damage of hepatitis B virus itself to the liver is very weak. Many patients have this virus, and the virus replication is very active, but it has no damage to the liver. We call this kind of patient a virus carrier, which can last for a long time, even for life without getting sick. Some patients may cause liver damage after carrying the virus, so there is no need for more treatment in clinic for those who carry the virus but have no liver damage. Virus carriers, especially patients with big three-positive and DNA positive, are very active in virus replication and highly contagious, but the main route of transmission of hepatitis B virus is blood transmission, and the general contact infectivity is relatively low.
What kind of situation does the hepatitis B laboratory sheet appear to indicate that treatment is needed?
The most important thing for hepatitis B patients is liver inflammation and damage, especially when the damage is serious (jaundice or other symptoms). The detection index is high transaminase or abnormal bilirubin. At this time, you need to go to the hospital for further examination and treatment.
Etiological examination should be distinguished from liver function examination. Once the abnormal cause (big or small, three positive) is found, you should go to the hospital for relevant examination, but don't be too nervous, because the virus is likely to be healthy for life, and only when the liver function is abnormal, you need active treatment.
What is the possibility of eliminating hepatitis B virus?
At present, it is really difficult to completely eliminate hepatitis B virus, and the complete clearance rate is only about 10%. At present, there are many drugs to treat hepatitis B. It is recommended that patients must take the drugs under the guidance of doctors and never take the drugs according to advertisements. This will not only lead to poor therapeutic effect, but also cause liver inflammation and aggravate the damage to the liver.
What is the best period of treatment?
The best period of antiviral treatment is when the liver is inflamed (transaminase is high), which reflects that the body's immunity has a certain effect on the virus. At this time, it will be very effective to use some antiviral drugs. If the liver is in a very stable state, the effect of antiviral drugs is really not ideal. In short, when patients need treatment, they should go to a specialized hospital for examination and then take medicine under the guidance of a doctor. For those virus carriers who do not need medication, the most important thing is to carry out regular monitoring, liver function monitoring for 3-6 months, and B-ultrasound once a year to monitor whether there is liver damage, and once it appears, it must be treated.
Can carrying hepatitis B virus for a long time develop into cirrhosis or liver cancer? What preventive measures are there?
Hepatitis B virus carriers may turn into chronic hepatitis and eventually develop into cirrhosis. It is very important to check the preventive methods regularly.
Only 20% or even less than 20% of patients with chronic hepatitis will develop cirrhosis. The incidence of liver cancer in patients with liver cirrhosis does not exceed 20%.
Both HbsAg and HBc are positive in pregnant women. Does it affect the fetus?
Both HBsAg and HBc are positive. If there is no vaccine before, 100% children will be infected. Now we have highly effective immunoglobulin and hepatitis B vaccine. When a child is born, high-efficiency immunoglobulin is injected first, and then hepatitis B vaccine is injected. Usually 80%-90% of hepatitis B virus can be blocked without being infected with hepatitis B, and there are still 10% cases.
general idea
1, hepatitis B detection includes liver function test and virus detection.
2. Having hepatitis B virus does not mean having liver damage.
3. Whether the liver function is normal determines the necessity of treatment.
4. Don't use drugs blindly.
References:
/article/ 102/ 1 1 1/2005 1 12393728 . htm
Reference:
Project unit reference range
Alanine transaminase ALT IU/L 0-40
Uric acid UA umol/L 140-430
Glucose concentration 3.9-6. 1
Triglyceride TG umol/L 0.4- 1.8
Total cholesterol T-CHOL umol/L 2.8-5.69
Elevated alanine aminotransferase (ALT) is a common clinical phenomenon. The liver is the largest detoxification organ in human body, and whether this organ is normal or not is very important to human body. Elevated ALT is an important indicator of liver function problems. Among the common factors, all kinds of hepatitis can cause the elevation of ALT, which is caused by the destruction of the liver. Some drugs, such as anti-tumor drugs and anti-tuberculosis drugs, can cause liver function damage. Excessive drinking and eating certain foods can also cause short-term liver damage.
ALT mainly exists in the cytoplasm of hepatocytes, and its intracellular concentration is 1000-3000 times higher than that in serum. As long as there is 1% hepatocyte necrosis, serum enzymes can be doubled. Therefore, ALT is recommended by the World Health Organization as the most sensitive indicator of liver function damage. But it is not organ-specific, and many diseases can cause its increase. Acute viral hepatitis increased significantly, while chronic hepatitis, active cirrhosis, liver cancer, liver abscess, myocardial infarction, myocarditis and heart failure increased moderately. It can also be slightly improved. Therefore, the evaluation of ALT elevation should be closely combined with clinical practice. Some elevated ALT is related to fatty liver and drinking. There are many liver-protecting drugs commonly used in clinic. However, the therapeutic effects of some drugs are easy to repeat, leading to some liver diseases that cannot be cured for a long time and a large number of liver cells are destroyed. How to protect liver cells is the key to protect liver function.
Alanine aminotransferase mainly exists in liver, heart and skeletal muscle. Damage or necrosis of liver cells or some tissues will increase alanine aminotransferase in blood. There are many diseases that can cause abnormal transaminase in clinic, so we must identify them.
1, viral hepatitis This is the most common disease that leads to the increase of transaminase. All kinds of acute and chronic viral hepatitis can cause the increase of transaminase. 2, toxic hepatitis A variety of drugs and chemicals can cause the increase of transaminase, but after stopping the drug, transaminase can return to normal.
3. Heavy or long-term drinkers will also increase alanine aminotransferase.
4. Liver cirrhosis, liver cancer cirrhosis active stage, transaminase is higher than the normal level, should be actively treated. 5, biliary tract diseases, cholecystitis, gallstones acute attack, often fever, abdominal pain, nausea, vomiting, jaundice, serum bilirubin and transaminase increased.
6, heart disease acute myocardial infarction, myocarditis, heart failure, alanine aminotransferase and aspartate aminotransferase are elevated, patients often have chest pain, palpitations, shortness of breath, edema. Cardiac examination showed positive signs and abnormal electrocardiogram.
7. Other infectious diseases, such as pneumonia, typhoid fever, tuberculosis and infectious mononucleosis. All of them have elevated transaminase, but these diseases have typical clinical manifestations and can be diagnosed by laboratory examination. In addition, acute soft tissue injury and strenuous exercise can also lead to a transient increase in transaminase. Therefore, it is necessary to go to the hospital for a comprehensive examination, find out the reasons and deal with them in time.