quantitative liver function test

Quantitative liver function tests are laboratory tests used to determine liver function. It is mainly used to understand the degree of damage and damage of various functions of the liver, and to judge its prognosis and therapeutic effect through dynamic observation. Mainly including indocyanine green (IGG) test, glucagon load test, arterial blood ketone body ratio (AKBR) determination, aminopyrine breath test, lidocaine metabolism test, amino acid scavenging test, synthesis of aminopurine acid test. Basic Information Specialist classification: Digestive examination classification: liver function test Applicable gender: whether men and women apply fasting: not fasting Included items: Aminopyrine breath test, A-Man's test Tips: You must not drink alcohol the day before the test. Pay attention to ensure adequate sleep before the examination, do not exercise vigorously. Normal value 1. Indocyanine green (IGG) test The normal human plasma c-AMP (pmol/ml) base value was 24.8, and the c-GMP (pmol/ml) base value was 4.3. 2. Glucagon load test The basic value of plasma c-AMP (pmol/ml) in normal subjects was 24.8, and the base value of c-GMP (pmol/ml) was 4.3. 3. Arterial blood ketone body ratio (AKBR) measured normal value AKBR ≥ 0.7. 4. The normal range of the ABT value of the aminopyrine breath test is between 5-10%. 5. Lidocaine metabolism test The concentration of lidocaine in normal people was 0.83±0.45μg/ml, and the concentration of MEGX was 127.25±26.25ng/ml. 6. Amino acid clearance test The normal value of TFPAA is about 0.7. 7. For the synthesis of ammonia hippuric acid, the concentration of ammonia hippuric acid in normal human serum is 40-70 μg/dl. Clinical significance Abnormal result 1. Indocyanine green (IGG) test reflects the anion transport function of hepatocytes, and is sensitive to the diagnosis of jaundice-free hepatitis or follow-up of its outcome, diagnosis of occult or inactive cirrhosis. 2. Glucagon load test The basic value of plasma c-AMP (pmol/ml) is less than 24.8, and the base value of c-GMP (pmol/ml) is less than 4.3, which is liver cancer and cirrhosis. 3. When the arterial blood ketone body ratio (AKBR) is determined by AKBR<0.7, the mitochondrial function is abnormal, and there may be insufficient oxygen energy supply, resulting in liver failure, cirrhosis, and liver cancer. 4. Aminopyrine breath test ABT value decreased in hepatitis, cirrhosis, alcoholic liver disease, fatty liver and liver cancer, and the early ABT value of primary biliary cirrhosis was normal. 5. Lidocaine metabolism test The average MEGX concentration of patients with cirrhosis for 60 min was 58.25±33.39 ng/ml. 6. Amino acid clearance test The value of TFPAA is greater than or less than 0.7, indicating that the liver metabolic function is abnormal. 7. For the ammonia hippuric acid synthesis test, the concentration of ammonia hippuric acid in the serum is greater than or less than 40 ~ 70μg / dl, which may be cirrhosis, hepatitis patients. Need to check patients with impaired liver function. Precautions 1. Be careful not to take the drug before the test, because some drugs will increase the burden on the liver, causing temporary damage to the liver function, which will lead to the accuracy of the liver function test results. 2. Pay attention to ensure adequate sleep before exercise, do not exercise vigorously, which may cause elevated transaminase, thus affecting the test results. 3. You must not drink alcohol the day before. Drinking alcohol will cause an increase in transaminase and affect the test results. 4. Prepare the glucagon physiological saline solution before the examination, pay attention to adjust the PH. Taboo when checking: 1. The venous blood taken should be fresh and checked immediately. 2. Remember to control the blood sugar concentration when checking. 3. If there is a small amount of inhalation in the test solution, spit it out immediately and rinse with water. If the test solution is spilled onto sensitive parts such as the eyes, rinse immediately with plenty of water. 4. The intensity of the puncture should be light, and the patient should be asked not to move. Inspection process 1. Indocyanine green (IGG) test: Rapid injection of indocyanine green from one side of the patient's arm vein (dose at 0.5 mg/kg body weight), immediately after injection, and 15 ml of blood from the contralateral arm vein after 15 minutes, serum separation . The colorimetric cyanide green concentration value was determined by a spectrophotometer. Calculate the retention rate of indole cyanide green for 15 min, and calculate the formula: the retention ratio of indole cyanide green = (C15 mg% ÷ 1 mg%) × 100%. 2. Glucagon load test After clear blood draw, glucagon was diluted with physiological saline, and intravenously injected for 5 minutes, and then blood was taken at 15, 30, and 60 minutes, respectively. The RIAl method was used to determine c-AMP. And c-GMP, and blood was taken for other liver function indicators, compared with the results after glucagon load. 3. Arterial blood ketone body ratio measurement In patients with 10% glucose infusion, the blood glucose was maintained at (6.7-11.2) mmol / L 2 ml of brachial artery blood, and the calculated AKBR value = AcAc (acetoacetic acid) / β-OHB (β-hydroxybutyric acid). 4. Aminopyrine breath test (1) After oral administration of 14C-aminopyrine (0.5-2mCi), the subject will be blown into the liquid flash bottle (seaamine 2mL, ethanol mL) at 30-120min. When 2mmoL CO2 and sea amine are completely When the reaction pH is less than 9, the indicator thymolphthalein changes from blue to colorless. (2) The radioactivity count of 14CO2 per mmoLCO2 was determined. (3) An average of 9 mmoL of endogenous CO2 was produced per kilogram of body weight per hour, and a radioactive count of exhaled breath for a total of 2 hours (or other time periods) was calculated. (4) Find the cumulative 2h (or other time period) exhaled air radioactivity count as a percentage of the given amount. 5. Lidocaine metabolic test administered to the subject intravenous bolus injection of lidocaine hydrochloride 1 mg / kg. After blood collection, 1.5 ml of blood was collected intravenously at 0, 3, 6, 10, 15, 30, 45, 60, 90, 120, 300 min, respectively, and serum was prepared to determine the concentration of lidocaine and its metabolite MEGX. 6. Determination of amino acid clearance In the morning, fasting, femoral vein trocar puncture, after the cannula was fed into 10cm, rapid injection of Proteamine 100ml at 0min, 2min, 5min, 10min, 15 and 20min, blood was taken from the forearm, and plasma samples were taken for TFPAA. 7. Test for the synthesis of ammonia hippuric acid Eat digestible food for breakfast on the test day. Oral sodium benzoate 3g was orally administered 2 hours after breakfast. The venous blood was taken 1 h after taking the drug to determine the serum p-aminobenzoic acid and the content of aminopurine. Not suitable for the crowd Those with advanced liver disease and liver function damage are not suitable for this examination, so as not to aggravate the condition. Adverse reactions and risks 1. Risk of infection: If you use an unclean needle, you may be at risk of infection. 2, the risk of allergies: if the patient can not tolerate the test reagents may cause an allergic reaction.