I posted an article about liver function tests before. I talked about the fact that normal transaminase does not necessarily mean that the liver is normal. Many friends do not understand. Since transaminase can more sensitively reflect the inflammatory state of the liver, why does the transaminase in the liver not change? ? Here, we continue the last article and talk about transaminase-related issues in detail.

Blood test for transaminase (alanine aminotransferase and aspartate aminotransferase) is normal, which means the liver is healthy?

Generally, people are concerned about whether there is a problem with their liver. They often refer to the two items of alanine aminotransferase and aspartate aminotransferase in the liver function in the blood test, because these two are the most abundant enzymes in the liver. They are produced by liver cells. Released into the blood when there is inflammatory irritation or necrosis. Aspartate aminotransferase (AST or GOT for short) and alanine aminotransferase (ALT or GPT for short) are the main objects to be tested when checking liver function, that is, the increase of these two indexes means that the liver is in a state of inflammation. Although the reference value of each laboratory is different, most of them are below 40 as normal.

But a normal liver index does not mean that the liver is healthy.

In clinical practice, we often see patients with a long history of chronic hepatitis. We follow the changes in the course of the disease due to inflammatory stimuli during the examination process, resulting in high and low levels of liver transaminase index. However, when liver cirrhosis or even liver cancer occurs, there is inflammation in the liver. It is often very mild or even stopped. At this time, the liver index may be normal, but in fact, the condition is serious, and many patients are chronic hepatitis B carriers. hardened. At the same time, because the liver has multiple physiological functions, multiple tests are required to evaluate whether the liver is healthy.

Generally speaking, in addition to looking at transaminase, it is also necessary to look at bilirubin and other indicators, that is, a complete liver function test, and it is best to match the abdominal color Doppler ultrasound, so as to have a more comprehensive understanding of the liver situation.

Blood test abnormal transaminase, but no symptoms, can be ignored?

Patients with abnormally elevated aminotransferases may not have symptoms, especially those without jaundice, but it may represent a variety of different liver diseases or diseases of other organs, such as viral hepatitis (A, B and C), autoimmune hepatitis, Steatohepatitis, alcohol-induced hepatitis, drug-induced hepatitis, liver cirrhosis, liver cancer, etc.

As for diseases of other organs, it can also cause abnormal transaminase. For example, the heart muscle has a lot of aspartate transaminase, so it will also be abnormally elevated in myocardial infarction, congestive heart failure, rhabdomyolysis, etc. Therefore, other examinations such as abdominal ultrasound, Hepatitis virus markers and other liver function items (such as alkaline phosphatase, glutamyl transpeptidase, total bilirubin, albumin and globulin, etc.) plus inquiries and pathological examinations, etc. The reason, if ignored, may delay the timing of medical treatment.

Abnormal transaminases have liver problems, should we hurry to eat healthy food that protects the liver?

When some people encounter abnormal transaminase in blood test, sometimes they do not seek medical treatment first, but like to ask their friends or watch media advertisements. Of course, there are other people who are enthusiastic about recommending healthy liver-protecting food based on their own experience. After taking it, it happens that the level of transaminase drops, and it is thought to be effective. However, the transaminase level of inflammation in the liver is often high and low during the disease tracking period, which may be related to the intensity of the body’s own immune cells fighting the virus.

Or it happens that the patient stops using the factors that cause abnormal transaminase, such as drugs, alcohol and other factors. At the same time, the healthy foods for liver protection on the market are often amino acids or vitamins, nutritional products, etc. Eating healthy foods should not have any special benefits for the liver, and if you use unproven health foods, these foods must also be detoxified by the liver. Metabolism, on the contrary, increases the burden on the liver, or delays the disease because of not seeking immediate medical attention.

Therefore, if abnormal liver index is found, it is still hoped that the patient can seek medical attention in time.

The patient has hepatitis B, and the blood has been tested for transaminase. Why does the doctor still need to check the amount of virus?

The viral load (HBV DNA) represents the replication of the virus in the body. It uses molecular biology techniques to detect whether there is a virus in the blood and estimate the amount of the virus. The viral load is not only used as a reference for whether treatment is needed. , and can predict whether the risk of developing liver cancer in the future is high .

But these need to be matched with the liver index value in order to make a good judgment. For example, in many young people, although the virus in the body is constantly replicating and the concentration is as high as several hundred million, the immune cells of the body will not attack the virus, and will not destroy the liver cells (immune tolerance period). Worrying about the amount of virus, it is not recommended to treat immediately. Although taking medicine can reduce the amount of virus, it has little benefit and wastes money.

If the liver index is abnormally elevated, if the alanine aminotransferase is greater than the upper limit of the normal value twice within six months (interval of 3 months), the hepatitis B virus amount exceeds 20,000 IU/ml, and the liver has a certain degree of fibrosis, the drug can be used.

However, if the virus cannot be detected, it may be that the amount of virus is very low and undetectable, and even hepatitis B surface antibodies (Anti-HBs) have appeared, but the hepatitis B virus is still hidden in the nucleus of liver cells (cccDNA), and it still needs to be tracked regularly. Because as long as the virus exists, it can still replicate in large numbers at an appropriate time.

The abnormal liver index is because of staying up late? Is it better to go to bed earlier?

Staying up late for a long time may reduce the body’s immunity, which may be unfavorable for existing chronic diseases, but there is no direct evidence that it will cause abnormal liver index in people with normal liver function, that is to say, for people with normal liver function, Staying up late will not directly cause liver cell damage.

If there is an abnormal liver index, you should find out the cause of the abnormal liver index, give treatment, or rule out the pathogenic factors, in order to make it return to normal, especially the hepatitis virus infection can not be cleared by early sleep, so it will not be early. Sleep will come naturally.