liver disease
Introduction
Introduction to liver disease Liver disease is a disease that occurs in the liver. Including hepatitis B, hepatitis A, hepatitis C, cirrhosis, fatty liver, liver cancer, alcohol liver and many other liver diseases. It is a common and extremely harmful disease and should be based on active prevention. Among the five major liver diseases, the most harmful is hepatitis B (abbreviated as hepatitis B). China is a liver disease country, especially hepatitis B (HBL) virus in the Chinese population, about 1.3% of the population is infected, for patients with liver disease It is said that family life, marriage, schooling, employment, going abroad, socializing are subject to varying degrees of restrictions and even discrimination. It is inevitable that life will be sorrowful. It is very important for everyone, because In this way, the confidence of treatment is lost, that is, many patients have lost the opportunity for treatment. However, all the victims are patients. Due to long-term non-treatment, busy work, psychological pressure, the virus continues to develop, delaying treatment time. , developed to cirrhosis, liver ascites, liver cancer. The situation is getting more and more serious, and it is nowhere to be reached. Viral hepatitis, liver fibrosis, fatty liver, alcoholic liver, drug-induced liver damage and liver cirrhosis, liver cancer and other liver diseases are one of the major diseases threatening human health in today's society. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of transmission: partial blood transmission, digestive tract transmission Complications: liver cirrhosis, liver cancer, arthritis, nodular polyarteritis
Cause
Cause of liver disease
The cause of liver disease:
Microbial infection (10%):
Infections of various pathogenic microorganisms, such as viruses, bacteria, parasites, protozoa, etc., among which hepatitis virus is the most important. Drug and toxic damage, due to the increasing opportunities for human exposure to chemicals and drugs, drug and toxic diseases have also increased.
Metabolic abnormalities (5%):
Metabolic abnormalities, because the liver is the center of material metabolism, any substance metabolism is closely related to the liver, such as abnormal metabolism of biliary pigment can cause jaundice, abnormal fat metabolism can lead to fatty liver, abnormal copper metabolism causes lenticular nucleus degeneration.
Environmental factors (70%):
About 70% of liver diseases are currently thought to be caused by three major environmental factors: viruses, chemicals, and alcohol (or malnutrition).
Genetic (15%):
Approximately 15% is associated with genetic factors of metabolism or other congenital abnormalities.
Pathological changes in liver disease:
It is summarized into six aspects: 1 Degeneration and necrosis of hepatocytes leads to abnormal cell morphology and function. 2 bile stasis, can be destroyed by hepatocytes to biliary dysfunction, can also be caused by biliary obstruction, pathologically mainly in the intrahepatic and bile duct system bile pigmentation and bile thrombosis. 3 Inflammatory reaction in the liver parenchyma, manifested by inflammatory cell infiltration, Kupffer cell proliferation and granuloma formation in the portal area. 4 interstitial fibrous tissue hyperplasia, especially in chronic hepatitis, the hepatic interstitial fibrous tissue hyperplasia centered on the portal area, which can extend and connect with each other. The original hepatic lobules were destroyed, separated, and reconstructed, and gradually developed into cirrhosis, leading to clinical portal hypertension. 5 liver occupying lesions, mainly seen in liver tumors and liver abscesses, lesions occupy part of the liver parenchyma and oppress the surrounding normal tissue. 6 hepatic vascular system damage, such as cirrhosis caused by decreased hepatic blood flow and portal hypertension. In addition, there are hepatic vein occlusion (Bad-Chiari II syndrome) and hepatic artery infarction.
Prevention
Liver disease prevention
1. Taste emotions, relax and avoid getting angry.
2. Vaccination to prevent hepatitis.
3, self-cleaning, refusing drugs and other ways to spread diseases.
4, quit smoking and alcohol, protect the liver.
5, enhance physical fitness, reduce the damage caused by medication.
Complication
Liver disease complications Complications liver cirrhosis liver cancer arthritis nodular polyarteritis
1. Hepatitis A damage to the liver:
Most patients with acute viral hepatitis recover within 6 months, especially hepatitis A and hepatitis B. However, if it is acute severe hepatitis or acute severe hepatitis, the mortality rate is very high, up to 60%-70%, and even if it recovers, it often develops into cirrhosis. Hepatitis A has evolved into chronic hepatitis, and cirrhosis is rare. However, about 15% of acute hepatitis B is converted into chronic hepatitis. A group of 1357 cases of acute hepatitis B were reported in China. After 2-10 years of follow-up, 16% and 2% of patients with chronic hepatitis and cirrhosis were found respectively, and about 0.6% of liver cancer occurred. The development of hepatitis C into chronic hepatitis is higher, about 26%-55%. It has been confirmed that some cirrhosis and liver cancer are evolved from hepatitis C. Therefore, hepatitis B and hepatitis C are very harmful, and a considerable number of patients have evolved from chronic hepatitis to cirrhosis and liver cancer.
2. Invasion of other organs of the body by hepatitis A:
It has been confirmed that the hepatitis virus can invade other organs, such as the hepatitis B virus marker can also be found in the kidney, pancreas, bone marrow, and thyroid gland. Therefore, viral hepatitis is also a harmful, that is, complications of extrahepatic tissues, such as arthritis, glomerulitis, nodular polyarteritis, etc., less common are diabetes, fatty liver, aplastic anemia , polyneuritis, pleurisy, myocarditis and pericarditis. Extrahepatic complications occur more commonly with hepatitis B.
3, the psychological damage of hepatitis A to patients:
Viral hepatitis not only harms the patient's body or even life, but also the psychological blow to the patient is very heavy. Whether it is hepatitis patients or virus carriers, life, social, job hunting, and further studies will be seriously affected, thus changing the fate of a lifetime. Such examples are endless. Therefore, both hepatitis patients and virus carriers should be treated actively, proactively and thoroughly. They must not be taken lightly on hepatitis, nor can they be considered to be carried for life without causing disease.
Symptom
Liver disease symptoms Common symptoms Liver disease face liver palm fatigue liver ascites fatigue skin yellow complexion dark splenomegaly
First, hepatitis B virus:
Hepatitis B is a disease caused by hepatitis B virus (HBV), which is mainly caused by inflammatory lesions of the liver and can cause damage to multiple organs. Hepatitis B is widely prevalent in all countries of the world, mainly invading children and young adults, and a small number of patients can be converted into cirrhosis or liver cancer. Therefore, it has become a worldwide disease that seriously threatens human health, and it is also the most widespread and most harmful disease in China. There is no certain epidemic period for hepatitis B virus, which can occur all year round, but it is mostly distributed. In recent years, the incidence of hepatitis B has increased significantly.
Second, cirrhosis:
Cirrhosis is a clinically common chronic progressive liver disease with diffuse liver damage caused by long-term or repeated action of one or more causes. In China, most of them are post-hepatitis cirrhosis, and a small part is alcoholic cirrhosis and schistosomiasis cirrhosis. Histopathology has extensive hepatocyte necrosis, residual hepatocyte nodular regeneration, connective tissue hyperplasia and fibrous septum formation, leading to structural destruction of the hepatic lobule and formation of pseudolobules. The liver gradually deforms and hardens and develops into cirrhosis. In the early stage, due to the strong liver compensatory function, there is no obvious symptom. In the later stage, liver function damage and portal hypertension are the main manifestations, and multiple system involvement is involved. In the advanced stage, upper gastrointestinal bleeding, hepatic encephalopathy, secondary infection, and spleen often occur. Complications such as hyperfunction, ascites, and cancer.
Third, fatty liver:
Fatty liver refers to a lesion with excessive accumulation of fat in liver cells due to various reasons. Fatty liver disease is a serious threat to the health of Chinese people and has become the second largest liver disease after viral hepatitis. It has been recognized as a common cause of occult cirrhosis. Fatty liver is a common clinical phenomenon, not an independent disease. Its clinical manifestations are asymptomatic, and the severe cases are fierce. In general, fatty liver is a reversible disease, which can be restored to normal after early diagnosis and timely treatment.
Fourth, alcohol liver:
Alcoholic fatty liver Alcoholic liver is the abbreviation of alcoholic liver disease. It is estimated that there are about 15 million to 20 million people drinking alcohol in the world. Among them, 10% to 20% (1.5 million to 4 million) have different degrees of alcohol. Liver disease. Alcoholic liver disease can be without any symptoms in the early stage, but at this time, pathological changes have occurred in the liver's internal tissues. Alcoholic liver disease can be mainly divided into three categories, namely alcoholic fatty liver, alcoholic hepatitis and alcoholic cirrhosis. These three forms can exist individually or in combination.
Fifth, liver cancer:
Liver cancer refers to malignant tumors that occur in the liver, including primary liver cancer and metastatic liver cancer. People's liver cancer is mostly referred to as primary liver cancer. Primary liver cancer is one of the most common malignant tumors in the clinic. Primary liver cancer can be divided into hepatocellular carcinoma, cholangiocarcinoma and mixed liver cancer according to cell type.
Liver cancer is the third most common malignant tumor with mortality after gastric cancer and esophageal cancer. The initial symptoms are not obvious. The late stage is mainly characterized by liver pain, fatigue, weight loss, jaundice and ascites. Clinically, Western medicine is generally used for surgery, radiotherapy and chemotherapy combined with traditional Chinese medicine. However, patients with advanced cancer have a lower cure rate due to the spread of cancer cells. Therefore, early detection, early diagnosis and early treatment of liver cancer should be done. Do a good job in the prevention of liver cancer, adhere to the "pipe water, food management, anti-hepatitis" liver cancer prevention seven-word policy.
Examine
Liver disease check
1. Liver function check:
(GOT, GPT) : When liver cells are necrotic, GOT and GPT are released into the blood after the destruction of the liver cell membrane. (GOT and GPT are not only present in liver cells but also in other parts of the body, such as muscles. Cells, brain cells, cardiomyocytes, etc., so elevated GOT and GPT are not necessarily all manifestations of impaired liver function, but they are the highest in liver cells. Therefore, some people think that it is called "inflammation index of liver". A liver function index is more suitable. The level of GOT and GPT does not have a certain relationship with the severity and prognosis of liver disease. Sometimes the immune system causes hepatocyte necrosis in order to remove the virus. At this time, the GOT and GPT values will rise, so GOT and GPT cannot be used alone. To judge whether the liver is out of order.
2. Abdominal ultrasound examination:
Although the blood test can reflect the liver function of the patient, it does not provide a clear message for cirrhosis or liver cancer. Especially for patients with partial cirrhosis and liver cancer, the liver function test results are sometimes within the normal range, and May be asymptomatic. Therefore, it is necessary to conduct blood tests and cooperate with ultrasonic examination.
3. Blood alpha-fetoprotein (AFP/fetal protein) check:
Alpha-fetoprotein (AFP/fetal protein) is an important indicator for the current examination of liver cancer. AFP/AFP is a manifestation of active growth of hepatocytes, so a small number of normal and pregnant women can be elevated than normal people. The growth of hepatocytes is active, and the alpha-fetoprotein/AFP secreted by them is significantly higher than that of normal people (so it can be called fetal protein). AFP can pass the placental barrier and increase the AFP in the mother's blood. When the growth of hepatocytes is active, AFP may also increase, but the degree of elevation is generally mild or the duration is short. When the alpha-fetoprotein/AFP is significantly increased or progressively elevated, it may be liver cancer. Specialist, go to the hospital for examination as soon as possible.
Diagnosis
Diagnosis and identification of liver disease
In addition to clinical symptoms and signs, the following examination methods are commonly used to provide a basis for diagnosis: 1 liver function test, commonly used in the determination of various serum enzymes and serum protein. 2 imaging examination, including X-ray examination, esophageal barium meal imaging, X-ray tomography, B-mode ultrasound examination. 3 radionuclide liver scan. 4 Liver biopsy. 5 laparoscopy.
A large number of immunological studies are being carried out on liver diseases, which plays an important guiding role in the clinical diagnosis and treatment of liver diseases, and also indicates the direction for future research work.
