The increase of alanine aminotransferase (GPT, 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. The increase of GPT is an important indicator of liver function problems. Among the common factors, all kinds of hepatitis can cause the increase of GPT, 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.
The normal reference value of alanine aminotransferase is 0 ~ 40 u/l.
GPT mainly exists in the cytoplasm of hepatocytes, and the 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, GPT is recommended by the World Health Organization as the most sensitive detection index 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 GPT elevation should be closely combined with clinical practice. Part of the reason for the increase of GPT 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.
Molecular mechanism: In liver cells, GPT transfers the amino group of alanine to α-ketoglutaric acid and the carbonyl group of ketoglutaric acid to alanine, so that alanine becomes pyruvate and α-ketoglutaric acid becomes glutamic acid.