impaired liver function
Introduction
Introduction The liver is the largest digestive gland in the human body. It is also the central station of metabolism in the body, and the liver is also the most vulnerable organ. Because most of the chemicals entering the body are transformed into the liver through the portal vein or systemic circulation of the gastrointestinal tract, the liver is most susceptible to toxic substances, causing chemical liver damage. Impaired liver function refers to certain pathogenic factors, including infectious and non-infectious, which cause changes in liver function, causing the liver to fail to perform its normal function, causing its function to undergo impaired changes. .
Cause
Cause
One of the causes of impaired liver function: excessive drinking
Long-term or intermittent heavy drinking can cause liver damage. The greater the amount of alcohol consumed and the longer it lasts, the more serious the consequences. Alcohol directly poisons liver cells and affects their structure and function. In reality, there are indeed many people who suffer from alcoholic hepatitis and fatty liver due to excessive drinking, which causes liver damage.
Two reasons for impaired liver function: staying up late
Busy work, often staying up late, lack of sleep, excessive fatigue, can cause relatively insufficient blood flow in the liver, affecting the nutrient and moisturization of liver cells, reducing the resistance, resulting in damaged liver cells difficult to repair and exacerbate the deterioration.
The third cause of liver damage: environmental pollution
The living environment of the city has deteriorated severely. The air is full of industrial waste gas and automobile exhaust gas. The working environment is polluted and the germs are alive. In such an environment for a long time, various chemical poisons enter the human body, which inevitably damages the liver.
Examine
an examination
Related inspection
Hepatitis A antibody serum albumin to globulin ratio (A/G) erythrocyte serum total bilirubin indirect bilirubin serum globulin (G, GL0)
The first step is to determine whether it is liver damage.
Damage to the liver will inevitably lead to abnormal liver function, but the current problem is that existing liver function tests, including enzymology and other biochemical tests, do not accurately reflect liver function, and some tests are not specific. For example, the most familiar alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are not completely unique enzymes in liver tissue, but also in tissues and organs such as myocardium and skeletal muscle. The damage can also be elevated with transaminase; alkaline phosphatase (AKP) and -glutamyltranspeptidase (-GT) are valuable indicators of biliary epithelial cell proliferation or biliary obstruction and inflammation. However, osteoblasts and fibroblasts can also secrete AKP. Recently, the author has consecutively received two cases of children with unexplained AKP increase, which is actually a mild increase in AKP in children's skeletal growth.
Some studies have found that about one-third of healthy physical examinations have hepatic dysfunction, but in fact such people do not necessarily have liver damage. Although it can be identified by isozymes or isomerases, clinicians are still necessary for the non-specific understanding of the above-mentioned "liver enzymes". The necessary review and understanding of the damage or functional status of other related organs contributes to the identification.
The second step is to understand the extent of liver damage.
In the liver function test, the routinely detected indicators such as transaminase do not reflect the overall appearance of liver function, but the obvious abnormalities of some items are directly proportional to liver function. Such as albumin, bilirubin and prothrombin time.
Prothrombin time (PT) or prothrombin activity reflects exogenous clotting factor levels. Although limited in sensitivity, it is an important liver function test that reflects the ability and level of liver synthesis of clotting factors. Patients with liver disease have significantly prolonged PT. Once patients with liver disease have prolonged PT, especially prolonged, it indicates that liver disease is serious and the prognosis is poor. Non-specialists tend to ignore the importance of PT in determining liver function.
It is worth mentioning that the level of transaminase that people are more familiar with is not necessarily directly proportional to the degree of liver damage.
The third step is to clarify the cause of liver damage.
The "cause" discussed here has two meanings.
1. Disease factors that directly cause liver damage. Viral hepatitis in China accounts for the first liver damage, followed by drug-induced liver damage, autoimmune liver damage, alcoholic liver damage and steatohepatitis.
Second, various factors that lead to further worsening of liver damage. Liver damage may not be a single factor. For example, if there is chronic viral hepatitis, hepatitis B virus and hepatitis C virus may be combined, which not only causes more serious liver damage, but also increases the difficulty of treatment; for example, alcoholic fatty liver is actually the same cause of disease. Two different pathological lesions are caused.
For different diseases, doctors should pay attention to the patient's condition on the basis of collecting medical history, apply various detection methods, and combine various diseases that may cause liver function damage to comprehensively consider the patient's symptoms and related causes. To find the most likely cause of symptomatic treatment.
Diagnosis
Differential diagnosis
For different diseases, doctors should pay attention to the patient's condition on the basis of collecting medical history, apply various detection methods, and combine various diseases that may cause liver function damage to comprehensively consider the patient's symptoms and related causes. To find the most likely cause of symptomatic treatment.
The first step is to determine whether it is liver damage.
Damage to the liver will inevitably lead to abnormal liver function, but the current problem is that existing liver function tests, including enzymology and other biochemical tests, do not accurately reflect liver function, and some tests are not specific. For example, the most familiar alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are not completely unique enzymes in liver tissue, but also in tissues and organs such as myocardium and skeletal muscle. The damage can also be elevated with transaminase; alkaline phosphatase (AKP) and -glutamyltranspeptidase (-GT) are valuable indicators of biliary epithelial cell proliferation or biliary obstruction and inflammation. However, osteoblasts and fibroblasts can also secrete AKP. Recently, the author has consecutively received two cases of children with unexplained AKP increase, which is actually a mild increase in AKP in children's skeletal growth.
Some studies have found that about one-third of healthy physical examinations have hepatic dysfunction, but in fact such people do not necessarily have liver damage. Although it can be identified by isozymes or isomerases, clinicians are still necessary for the non-specific understanding of the above-mentioned "liver enzymes". The necessary review and understanding of the damage or functional status of other related organs contributes to the identification.
The second step is to understand the extent of liver damage.
In the liver function test, the routinely detected indicators such as transaminase do not reflect the overall appearance of liver function, but the obvious abnormalities of some items are directly proportional to liver function. Such as albumin, bilirubin and prothrombin time.
Prothrombin time (PT) or prothrombin activity reflects exogenous clotting factor levels. Although limited in sensitivity, it is an important liver function test that reflects the ability and level of liver synthesis of clotting factors. Patients with liver disease have significantly prolonged PT. Once patients with liver disease have prolonged PT, especially prolonged, it indicates that liver disease is serious and the prognosis is poor. Non-specialists tend to ignore the importance of PT in determining liver function.
It is worth mentioning that the level of transaminase that people are more familiar with is not necessarily directly proportional to the degree of liver damage.
The third step is to clarify the cause of liver damage.
The "cause" discussed here has two meanings.
1. Disease factors that directly cause liver damage. Viral hepatitis in China accounts for the first liver damage, followed by drug-induced liver damage, autoimmune liver damage, alcoholic liver damage and steatohepatitis.
Second, various factors that lead to further worsening of liver damage. Liver damage may not be a single factor. For example, if there is chronic viral hepatitis, hepatitis B virus and hepatitis C virus may be combined, which not only causes more serious liver damage, but also increases the difficulty of treatment; for example, alcoholic fatty liver is actually the same cause of disease. Two different pathological lesions are caused.
For different diseases, doctors should pay attention to the patient's condition on the basis of collecting medical history, apply various detection methods, and combine various diseases that may cause liver function damage to comprehensively consider the patient's symptoms and related causes. To find the most likely cause of symptomatic treatment.
