What does TBTU mean on the liver function test sheet? You may be mistaken, right? It should be TBIL, total bilirubin.
The normal reference value is1.7-17.1μ mol/L, but the reference value will be different with different methods and standards adopted by different hospitals. The normal reference value shall be indicated on the regular report form.
What does liver function test transaminase mean? Transaminase reflects the health status of the liver. Transaminase is an essential "catalyst" in the process of human metabolism, which mainly exists in liver cells. Inflammation, necrosis and poisoning. Occurs in liver cells, causing liver cells to be damaged, and transaminase will be released into the blood, thus increasing serum transaminase. Usually, alanine aminotransferase is the main transaminase in physical examination. 1% hepatocyte injury can increase the concentration of ALT in blood by 1 fold. Therefore, ALT level can sensitively monitor whether the liver is damaged. It is normal for transaminase levels to be between 0 and 40. If it is beyond the normal range, the doctor will recommend a second inspection to eliminate the possibility of errors caused by laboratory equipment failures, operational errors and other factors. If the level of transaminase is still high, it is mostly caused by viral hepatitis or other liver diseases. However, in order to determine whether it is viral hepatitis, other tests are needed, combined with comprehensive analysis of medical history, symptoms and signs. Even if it is confirmed to be viral hepatitis, the condition cannot be judged simply by the degree of elevation of ALT, because for severe hepatitis, ALT may decrease with the deterioration of the condition, probably because there are fewer living liver cells and less transaminase released into the blood. High transaminase is not all hepatitis, but high ALT only means that the liver may be damaged. Besides hepatitis, many other diseases can cause the increase of transaminase. Professor Wang pointed out that there are mainly the following situations: First, many tissues in the human body contain transaminase, such as myocarditis and myocardial infarction, which may increase aspartate transaminase. Secondly, if there are biliary obstructive diseases such as gallstones, the level of transaminase in the blood may increase due to cholestasis. In addition, for some people who don't look serious, alcoholic hepatitis may be caused by long-term alcoholism, or fatty liver caused by unreasonable diet structure, leading to high transaminase. Fatigue may also increase transaminase. For healthy people, the increase or decrease of transaminase level in the normal range does not mean that there is something wrong with the liver because transaminase is very sensitive. The level of transaminase in healthy people may fluctuate at different times of the day. In addition, the level of transaminase in healthy people may temporarily exceed the normal range. Severe exercise, overwork or eating greasy food recently may temporarily increase transaminase. If you work overtime the night before the transaminase test, sleep badly, or eat fried food for breakfast before the physical examination, the test results may be beyond the normal range. A person just ran a few laps on the playground and immediately checked his transaminase level, and the result may be higher than the normal range. If these conditions lead to the increase of transaminase, as long as you have a good rest, you will find that the level of transaminase will return to normal after a period of time. There is also a situation that will lead to an increase in transaminase. When you are sick, take drugs that will damage your liver, such as erythromycin, tetracycline, sleeping pills, antipyretic and analgesic drugs, birth control pills, and traditional Chinese medicines such as Pinellia ternata, Areca catechu and indigo naturalis. After stopping using these drugs, the level of transaminase will soon return to normal. In short, if you find that your transaminase is on the high side, don't be too nervous, don't worry that you have serious liver disease, but you must also pay enough attention, have a good rest, and receive regular review and treatment in time. Find out the reasons and give targeted treatment; Reference can be made to the following categories: Schisandra preparation and its chemical preparation biphenyl diester; Sophora Tonkinensis preparation Ganyanling injection; Glycyrrhiza extract and its preparations glycyrrhizic acid and diammonium glycyrrhizinate injection; Sedum sarmentosum preparation, Sedum sarmentosum syrup and suspension tablets; Ligustrum lucidum. Fruit acid tablets; Silymarin preparation Yiganling, silibinin gum, etc. The above drugs mainly promote the regeneration of liver cells and improve the detoxification function of liver. Eliminate liver fat deposition, improve liver metabolic function, accelerate the removal of ALT from blood and reduce alanine aminotransferase by reducing the escape of ALT from liver cells. If the single item increases, the possibility of liver disease is less. Other reasons, such as fatigue and taking certain drugs, should also be considered, and the reasons need to be found out before treatment.
What does the warning H on the liver function test sheet mean? H is a high warning value. If it is exceeded, the indicator is abnormal. As for the physical problems corresponding to each index, you need to ask your doctor.
What can the liver function test list check to see if there is liver disease!
What do items 2, 4 and 5 in the liver function test represent as positive? Is it liver function test or hepatitis B?
It's best to explain which ones. For example, the second item of liver function in our hospital is AST, which is different from what my friends upstairs said.
Many people don't know how to read the liver function test sheet. In fact, reading a liver function test sheet is not as difficult as expected. Let's invite liver disease experts to teach you, so that you can have a deeper understanding of what each index on the liver function test sheet means. The higher the levels of transaminase, bilirubin and globulin in biochemical indexes of liver function, the more serious the condition of liver, while the lower the albumin index synthesized by liver, the deeper the damage of liver. Patients can know whether each index is high or low only by comparing the actual personal examination value with the normal value of the hospital. Precautions for liver function examination The five indexes of liver function are general. After the biochemical indexes of liver function are checked, if the liver function is abnormal, five virus indexes of hepatitis B should be checked, including hbsag (surface antigen), hbsab (surface antibody), hbeag(e antigen), hbeab(e antibody) and hbcab (core antibody) to see if it is because of hepatitis B virus infection. After these five tests are combined with the quantitative analysis of hbvdna, the number of viruses can be known, and the best treatment opportunity can be determined by combining the changes of transaminase. Of course, besides knowing yourself, it is also important to find a regular specialized hospital for treatment. It is recommended that Beijing Hepatology Hospital, the best hepatopathy hospital in China, has advanced hepatopathy diagnosis and treatment equipment in China, among which a number of sophisticated medical equipment such as high-speed spiral CT, nuclear magnetic resonance, HBV gene detection system for hepatitis B virus and liver B-ultrasound have reached the first-class level in China, providing the most scientific basis for accurate diagnosis.
Many tests generally require liver function tests, but many patients don't understand what some items on the liver function test list mean. Experts from Jinan Traditional Chinese Medicine Hepatology Hospital will tell you in this article. According to the expert of liver disease in Jinan Hospital of Traditional Chinese Medicine, it is mainly analyzed according to various index items, showing as: 1, transaminase: mainly divided into alanine transaminase and aspartate transaminase, and ALT and AST will increase when liver cells die. The degree of its increase is consistent with the degree of liver cell damage, so it is the most commonly used index of liver function at present. The elevation of ALT and AST and AST/ALT ratio are different in patients with different types of hepatitis. 2. Albumin: In patients with chronic hepatitis and liver cirrhosis, albumin decreases, while globulin production increases, resulting in the inversion of A/G ratio. The normal value of serum albumin is 35-50g/L, globulin is 20-30g/L, and the A/G ratio is 1.3-2.5. 3. Serum total bilirubin: it is the sum of direct bilirubin and indirect bilirubin. Acute icteric hepatitis and chronic active hepatitis, total bilirubin, direct bilirubin and indirect bilirubin often rise at the same time, suggesting severe hepatitis. 4. Alpha-fetoprotein: In viral hepatitis, the increase of alpha-fetoprotein is usually small, generally less than 300μ g/L. However, the alpha-fetoprotein in primary liver cancer is often greater than1000μ g/L.5.. Alkaline phosphatase and GGT: Alkaline phosphatase and glutamyl transpeptidase are commonly used indicators for the diagnosis of biliary diseases. The alkaline phosphatase in normal human serum mainly comes from bone, which is produced by osteoblasts, passes through the blood to the liver and is discharged from the biliary system. Therefore, this enzyme is significantly increased in cholestatic hepatitis and extrahepatic obstruction. As the best liver disease hospital in Shandong Province, Jinan Traditional Chinese Medicine Liver Disease Hospital has advanced diagnosis and treatment equipment, including "superoxide autologous blood activation therapy" and "seventy-six syndrome differentiation and recovery therapy". The cure rate is as high as 98%, with high curative effect and quick response. Can effectively avoid the variation and drug resistance of hepatitis B virus, comprehensive treatment, and truly achieve efficient treatment results. It is a trustworthy and good hospital for the majority of hepatitis B patients. Superoxide autologous blood activation therapy is the most effective therapy for liver disease at present. This technology can quickly identify and lock the mutated virus for encirclement and elimination, prevent the occurrence of refractory hepatitis B and hepatitis C, and hepatitis B virus will not mutate to produce drug resistance. Short course of treatment and wide range of users. After 7 years of clinical verification, it is safe, painless and has no toxic or side effects. I wish you a speedy recovery!
Disease analysis: Hello, if transaminase and bilirubin in the liver function test sheet are higher than normal, it means that liver cells are damaged. Suggestion: Combined with your age, the most common diseases that cause liver cells are viral hepatitis, fatty liver and intrahepatic bile duct stones may also cause the increase of transaminase and bilirubin. You can combine your own liver function report results and symptoms for further examination. The examinations that can be done are upper abdominal B-ultrasound and hepatitis B..
How to edit the main indexes of liver function test sheet
One,
Liver function test sheet [1]
Alanine transaminase (alt): 0 ~ 40μ/l
2. aspartate aminotransferase (ast): 0 ~ 40μ l.
Three. Alkaline phosphatase: 30-90u/L.
Glutamyl transferase (GGT): less than 40 units
5. Total protein (TP): 60-80g/L; Albumin (a): 40-55g/l; Globulin (g): 20-30g/L; Albumin (A)/ globulin (g): 1.5-2.5: 1.
6. Total bilirubin:1.71-17.1μ mol/L (1-10 mg/L); Indirect bilirubin1.7-13.7 μ mol/l; Direct bilirubin:1.71-7 μ mol/l (1-4 mg/l).
Seven, alpha-fetoprotein (AFP):
It is mainly synthesized in fetal liver, and its molecular weight is 69000. At 13 weeks of fetal life, AFP accounts for13 of total plasma protein. It reached its peak at 30 weeks of pregnancy and then gradually declined. The plasma concentration at birth is about 65,438+0% of the peak value, about 40mg/L, and it is close to the adult level (less than 30 μ g/L) at one year old [2].
2 laboratory description editing
Liver function examination is to monitor various indexes related to liver function and metabolism through various biochemical experiments to reflect the basic situation of liver function. Non-liver function test sheet is the display of liver function test results. Doctors can judge a person's liver condition well by checking the liver function test sheet. If there are lesions, doctors can draw corresponding conclusions according to the patient's examination results. Take this as a reference. For different hospitals, the reference value of the results displayed by the liver function test sheet may be different, which is determined by different hospitals.
Liver function test sheet shows the results of transaminase, such as alanine aminotransferase, aspartate aminotransferase, albumin, globulin, white ball ratio, bilirubin, bile acid and so on. The content displayed in each test result represents different meanings. By analyzing the liver function test sheet and comparing it with the reference value, we can judge whether a person has a liver problem or the severity of the problem, but many people can't understand the liver function test sheet, so it is very important to learn to read the liver function test sheet [3].
3 basic project editing
(1) index reflecting liver parenchymal damage
It mainly includes alanine aminotransferase and aspartate aminotransferase, among which ALT is the most commonly used sensitive index. When 1% hepatocytes are necrotic, the serum ALT level can be increased by 1 fold. AST continues to rise, and the value exceeding ALT often indicates that the liver parenchyma is seriously damaged, which is a sign of aggravation of chronic degree.
(2) Indicators reflecting bilirubin metabolism and cholestasis
It mainly includes total bilirubin (TBil), direct and indirect bilirubin, urinary bilirubin, urinary urobilinogen, blood bile acid (TBA), γ -glutamyltranspeptidase (γ-GT) and alkaline phosphatase (ALP). The above indexes can be increased when liver cells are degenerated and necrotic, bilirubin metabolism is impaired or liver cholestasis occurs. When hemolytic jaundice occurs, bilirubin may increase indirectly.
(3) Indicators reflecting the synthetic function of the liver.
It mainly includes the time and activity of albumin, prealbumin, cholinesterase and prothrombin. When albumin and cholinesterase decrease for a long time, and prothrombin activity decreases, and vitamin K supplementation can't correct it, it shows that normal liver cells are gradually decreasing, the functions of synthetic protein and coagulation factors of liver cells are poor, the function of liver reserve is decreased, and the prognosis is poor.
(4) Indicators reflecting hepatic fibrosis
It mainly includes type Ⅲ procollagen (PⅢ P), type Ⅳ collagen (C-Ⅳ), hyaluronic acid (HA) and laminin (LN), which is helpful for the diagnosis of liver fibrosis and early cirrhosis.
(5) detection index of liver coagulation function
Liver can synthesize all coagulation factors except factor III and factor A chain, which plays an important role in maintaining normal coagulation function. The synthesis of coagulation factors in patients with liver disease is reduced, and in severe cases, gingival and nasal mucosa bleeding, facial ecchymosis and gastrointestinal bleeding may occur. Generally speaking, factor ⅶ appears first, with the largest decline, followed by factor Ⅱ and factor ⅹ, and finally appears, with the smallest decline.
A, prothrombin time (PT)
The normal value was 1 1 ~ 15 seconds, which was 3 seconds longer than that of the normal control group. The PT of acute hepatitis and mild chronic hepatitis is normal, and the PT of patients with severe hepatocyte necrosis and cirrhosis is obviously prolonged. PT is a sensitive index to reflect the degree of hepatocyte injury and to judge the prognosis.
B, prothrombin activity (PTA)
The normal value is 80%~ 100%, and its clinical significance is the same as that of PT.
Liver thromboplastin test (HPT)
It is one of the methods to measure the liver reserve function, and it can sensitively and reliably reflect the synthesis disorder of coagulation factors Ⅱ, ⅶ and ⅹ caused by liver damage. Clinical trials show that HPT in patients with acute hepatitis, chronic active hepatitis, liver cirrhosis and subacute severe hepatitis decreases at all stages of the course of the disease. The more serious the condition, the lower the HPT. When liver disease develops to hepatocyte failure, its HPT drops obviously, generally below 0.5. If HPT gradually recovers in turn, the prognosis is good.
4 Latest Project Editor
The relevant departments have added five items of liver function examination, and the new items in the list of liver function examination are as follows:
(1) glycocholic acid (CG): When liver cells are damaged or bile stagnates, the content of CG in blood is obviously increased, reflecting that liver cell damage is more sensitive than ALT commonly used in clinic, and mild liver injury can be found early, which is helpful to distinguish the severity of chronic hepatitis.
(2) Ferritin (SF): It is synthesized and stored in the liver. Inflammation of hepatocytes can increase SF synthesis, and degeneration and necrosis of hepatocytes can release SF into the blood. The increase of SF is parallel to the severity of hepatocyte injury, but it can be significantly reduced in severe hypoproteinemia and iron deficiency anemia.
(3) Prealbumin (PA): It has certain significance for early detection of severe hepatitis and chronic liver injury. The more serious the illness, the lower the value.
(4) Transferrin (TF) is a glycoprotein synthesized by the liver, and its main function is to transport iron. TF increased in acute hepatitis, but decreased in chronic hepatitis and liver cirrhosis. TF decreased in other infections, but increased in iron deficiency anemia and late pregnancy.
(5) Bile acid (TBA) is the main organic anion excreted by the liver, and its metabolism is mainly controlled by the liver. When liver function is damaged, its increase is often earlier and more obvious than bilirubin. Therefore, it can reflect liver injury more sensitively.
5 function item editing
First, the synthetic function of the liver
(1) albumin
Liver is the only place to synthesize albumin, and serum albumin level is one of the good indicators to reflect chronic liver injury. The decrease of serum albumin level can be seen in: insufficient nutrient intake, disordered synthesis, excessive consumption and increased loss. Serum albumin level in patients with chronic liver disease can reflect the ability of liver to synthesize albumin and the change of albumin volume distribution. If the serum albumin level decreases and is not easy to recover, the prognosis is often poor.
(2) Prothrombin time
When liver function is damaged, the related coagulation factor synthesis disorder can lead to PT prolongation, which is one of the early prediction indexes of liver function abnormality. Prolonged PT and uncorrectable vitamin K indicate poor liver function. PT is an important early diagnostic index in fulminant liver failure.
(III) Lipids and lipoproteins
Lipids and lipoproteins are not sensitive indicators of liver injury, but when liver cells are damaged, the serum cholesterol ester level drops, which is proportional to the degree of liver injury. In chronic liver disease, lipoprotein is decreased, and its level is negatively correlated with transaminase and bilirubin.
Second, the excretion function of the liver.
bilirubin
Bilirubin is one of the important indexes of liver function, and it is also the TBIL of normal total bilirubin level.
Note: 1. When liver function is normal, TBIL
Third, the serum enzyme level.
(1) ALT and AST:ALT is more specific than AST.
1. when ALT >；; Normal 10 times, there must be liver damage (such as chronic hepatitis B)
2. ALT and AST are elevated in biliary diseases, but
3.AST/ALT ratio: (1) to estimate the degree of liver damage: the greater the damage, the more serious the damage; (2) Differential diagnosis of liver disease: alcoholic hepatitis >; 2. Chronic hepatitis B >; 1 There may be liver fibrosis or cirrhosis.
(2) Alkaline phosphatase
1.ALP & gt Four times normal: cholestasis syndrome.
2.ALP & gt is 2.5 times normal, ALT, ast.
3.ALP & gt is 2.5 times normal, alanine aminotransferase and aspartate aminotransferase & gt are 8 times normal: 90% is viral hepatitis.
(3) glutamyl transpeptidase GGT
GGT of 90% patients with hepatobiliary diseases increased, GGT >；; Normal 10 times, mostly due to alcoholic hepatitis, intrahepatic and extrahepatic cholestasis and primary liver cancer.
Four. Evaluation of liver enzymology indexes
1. A large sample survey of healthy people in Britain found that 6% of asymptomatic normal people had elevated ALT and AST, and all the test results of 5% of normal people were outside the "normal" range. So some abnormal liver tests are not really abnormal.
2. The treatment method for the increase of single transaminase level is: check it again. If the increase is more than 2 times normal, further inspection is needed.
Verb (abbreviation of verb) matters needing attention
When carrying out liver function examination, it is necessary to have an empty stomach, because the ingredients in food will change the content of liver function examination indexes, which will easily lead to incorrect liver function examination results, thus leading to misdiagnosis.
6. Does exercise affect the liver function test?
Exercise has an effect on liver function, which can cause abnormal liver function, especially strenuous exercise. Because in the process of exercise, muscle activities are mainly affected by some muscle-related enzymes, such as creatine kinase and lactate dehydrogenase. Creatine kinase can be increased dozens of times after strenuous exercise, and long-term physical exercise will also increase the level of sex hormones.
Therefore, in order to avoid misdiagnosis of liver function test, it is suggested that patients must not do strenuous exercise before doing liver function test, and also be careful not to overwork, so as not to affect the results of liver function test.