High levels of aspartate aminotransferase (AST) in serum
Introduction
Introduction Aspartate aminotransferase, also known as aspartate aminotransferase, is abbreviated as AST, which is a kind of liver function. Transaminase is an indispensable "catalyst" in the body's metabolic process and is mainly found in hepatocytes. When hepatocytes develop inflammation, necrosis, poisoning, etc., causing damage to the liver cells, the transaminase is released into the blood, causing the serum transaminase to rise. The high clinical symptoms of aspartate aminotransferase are also common symptoms of hepatitis. They are generally low-grade, oily, nausea, vomiting, fatigue, poor appetite, liver swelling and so on. Focusing on this condition is treating the primary disease.
Cause
Cause
The cause of high levels of aspartate aminotransferase (AST) in serum
Under normal conditions, aspartate aminotransferase is present in tissue cells, with the highest content of cardiomyocytes, followed by the liver. There is very little serum. When the tissue is cytopathic, the enzyme is released into the blood.
Various liver diseases can also cause an increase in AST. Such as acute and chronic hepatitis, toxic hepatitis.
Heart failure, pleurisy, nephritis, taking certain drugs such as isoniazid, chlorpromazine, luminal, etc. can increase AST.
Examine
an examination
Related inspection
Serum aspartate aminotransferase serum aspartate aminotransferase and serum trough-alanine aminotransferase ratio urinary aspartate aminotransferase (GOT)
Blood biochemical examination: aspartate aminotransferase (AST), normal reference value: 5-35U / L.
Aspartate aminotransferase has the highest content in cardiomyocytes, but its serum concentration can also be increased in liver damage. It is often used as an auxiliary test for myocardial infarction and myocarditis. The normal value of aspartate aminotransferase is 0-40/L. When the alanine aminotransferase (ALT) is significantly increased and the ratio of AST/ALT is >1, it indicates the damage of liver parenchyma.
Diagnosis
Differential diagnosis
Symptoms of high levels of aspartate aminotransferase (AST) in serum
There are many diseases in the clinic that can cause elevated aspartate aminotransferase and must be identified.
1, viral hepatitis: This is the most common cause of elevated aspartate aminotransferase, all kinds of acute and chronic viral hepatitis, both significantly increase the aspartate aminotransferase, but its increase is not exactly the same as the severity of liver disease. At the same time, bilirubin, zinc turbidity and glutamyl transpeptidase may also be responsible for the elevation of aspartate aminotransferase.
2, cirrhosis and liver cancer: cirrhosis activity, bilirubin and aspartate aminotransferase increased, for bilirubin and aspartate aminotransferase should be actively treated. Most of the transaminase in patients with primary or metastatic liver cancer is normal or mild aspartate aminotransferase is elevated. However, the levels of alkaline phosphatase and alpha-fetoprotein are increased, and B-mode ultrasound or CT examination is helpful in the diagnosis of the cause of elevated aspartate aminotransferase.
3, heart disease: acute myocardial infarction, myocarditis, heart failure, alanine aminotransferase and aspartate aminotransferase increased, is also one of the reasons for the increase in aspartate aminotransferase. Patients often have chest pain, palpitations, shortness of breath, and edema. Cardiac examination has positive signs and abnormal ECG.
4, toxic hepatitis: a variety of drugs and chemical agents, such as erythromycin, tetracycline, isoniazid, phenylbutazone, methotrexate, contraceptives, etc. can cause bilirubin and aspartate aminotransferase increased, but chronic indicators Less changes and often accompanied by other allergic reactions. After stopping the drug, the aspartate aminotransferase can be restored to normal.
5, alcoholic liver disease: In recent years, the incidence of alcoholic liver disease has gradually increased. Alcoholic hepatitis, fatty liver and alcoholic cirrhosis can occur in large or long-term drinkers. Patients with elevated alanine aminotransferase and aspartate aminotransferase have clinical manifestations similar to hepatitis. When suffering from fatty liver, the levels of blood cholesterol and triglycerides are increased. This is one of the reasons for the increase in aspartate aminotransferase.
6, biliary tract disease: cholecystitis, cholelithiasis acute attack, often fever, abdominal pain, nausea, vomiting, jaundice, blood bilirubin and aspartate aminotransferase increased. After the inflammation is controlled, the reason for the elevation of the aspartate aminotransferase is relieved, and the aspartate aminotransferase phenomenon disappears, and B-ultrasound or X-ray examination can be performed.
7. Some other infectious diseases: such as pneumonia, typhoid fever, tuberculosis, infectious mononucleosis, etc., are the causes of elevated aspartate aminotransferase, but these diseases have typical clinical manifestations and can be tested by laboratory. , clear diagnosis. In addition, acute soft tissue injury, strenuous exercise, pregnancy, there may also be a rise in transient aspartate aminotransferase.
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