acute liver disease
Introduction
Introduction to acute liver disease Common liver diseases include hepatitis, cirrhosis, liver abscess, and primary liver cancer. Hepatitis is mainly caused by chronic hepatitis. According to the etiology, it is divided into chronic viral hepatitis, autoimmune hepatitis, toxic hepatitis, hereditary diseases and other causes. Chronic hepatitis. Hepatitis B is the most common form of hepatitis B. Hepatitis B virus is a worldwide infectious disease. According to statistics, there are more than 280 million people carrying hepatitis B surface antigen in the world. China is a high-incidence area of hepatitis B. Currently there is a chronic hepatitis B disease. About 30 million people. There are 400,000 people who die of hepatitis B after liver disease every year. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of transmission: partial blood transmission, digestive tract transmission Complications: liver cancer, liver cirrhosis, liver abscess
Cause
Cause of acute liver disease
Pathological changes in liver disease:
1. Hepatocyte degeneration and necrosis lead to abnormal cell morphology and function.
2, bile stasis, can be destroyed by liver cells to secrete bile dysfunction, can also be caused by biliary obstruction, pathologically mainly in the liver cells and bile duct system bile pigmentation and bile thrombosis.
3. Inflammatory reaction in the liver parenchyma, which is characterized by inflammatory cell infiltration, Kupffer cell proliferation and granuloma formation in the portal area.
4, interstitial fibrous tissue hyperplasia, especially in chronic hepatitis, with the portal area as the central liver interstitial fibrous tissue hyperplasia, 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 liver 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
Acute 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
Acute liver disease complications Complications liver cirrhosis liver abscess
1. Astragalus: The liver is the center of bilirubin metabolism. When the condition is severe, the concentration of bilirubin in the blood increases due to the ingestion, binding, secretion, excretion and other obstacles of bilirubin. When the concentration of bilirubin in the blood increases, bilirubin is excreted from the urine, making the urine darker. It is the earliest manifestation of jaundice. However, the lack of sweat and drinking water, some drugs can also cause changes in the color of urine, should pay attention to the difference. When the concentration of bilirubin in the blood continues to increase, it can cause jaundice in the eyes and skin. Due to the discharge of bile acids, the concentration of bile acids in the blood is increased, and excessive bile acids are deposited on the skin. Stimulate the peripheral nerves, causing itchy skin.
2, liver pain: lack of pain nerves inside the liver, hepatitis B generally no severe pain. However, there is a thin film on the surface of the liver, called the liver capsule. There is a distribution of pain nerves on the liver capsule. When the liver is inflamed and enlarged, the liver capsule is tense and the pain nerve is stimulated. Therefore, some patients may have the right upper abdomen. The right season ribs are uncomfortable and painful. If the pain is severe, pay attention to the possibility of biliary diseases, liver cancer, gastrointestinal diseases, so as not to misdiagnose.
3, hepatosplenomegaly: due to inflammation, congestion, edema, cholestasis, hepatitis B often has liver enlargement. If the chronic inflammation period does not heal, recurrent. Liver fibrous connective tissue hyperplasia, liver texture hardens. In the late stage, due to the destruction of a large number of liver cells, the fibrous tissue contracts and the liver can shrink. In the early stage of acute hepatitis or chronic hepatitis, the spleen has no obvious swelling, and may be due to hyperplasia of the spleen reticuloendothelial system and portal hypertension. The spleen is congested and causes swelling of the spleen. Persistent progressive splenomegaly suggests cirrhosis.
Symptom
Acute liver disease symptoms common symptoms liver disease face liver palm liver swelling fatigue fatigue
The performance of liver disease is very concealed. The most prominent symptoms are fatigue and lack of diet. Common symptoms are pain or discomfort, nausea, tired of greasy, fullness after eating or jaundice, dry mouth, stool or dry or sputum, yellow urine, or low fever, dizziness, tinnitus, complexion and sallowness. If it is cirrhosis, in addition to the clinical manifestations of hepatitis, there are ascites, abdominal wall blood vessels, edema around the body, oliguria, liver palm, spider mites, severe cases may also be bleeding.
Examine
Acute liver disease examination
1. Liver function test:
(GOT, GPT): When the 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 the 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 acute 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.
