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Liver biochemical test, commonly known as liver function test, is through various biochemical test methods to detect the liver function metabolism of various indicators to reflect the basic status of liver function. What is
amino transferase? Amino transferase is the main index of biochemical testing of the liver.
ampicillin transfer enzyme abnormality is a very common clinical cause of patient seeking treatment, clinicians who do not understand it may miss out on potential liver disease, and overinterpretation of it and subsequent further evaluation examination, may bring unnecessary psychological pressure and financial burden to patients and families.
for a long time, many patients and even non-specialists have a misunderstanding of the understanding of amino metastase, the following small compilation from the relevant literature, consensus and guidelines to extract a number of knowledge points to help readers understand the clinical significance of amino metastase.
1, generally in accordance with international practice, the alT's normal reference value upper limit (ULN) as male 40IU/L, female 35IU/L.
but the study shows that the current widely used serum amino metastase reference value may be high, 2016 American Gastroenterology Society abnormal liver biochemical test evaluation clinical guidelines, the normal reference value of serum amino transferase is 29 to 33IU/L for men, 19 to 25 IU/L in women.
2, ALT and AST are widely distributed in body tissue cells, ALT is mainly distributed in the liver and kidneys, AST is mainly distributed in the heart, liver, skeletal muscle and kidneys.
ALT is only present in cytoplasm, while AST is present in both mitochondrial and cytoplasm, where mitochondrial AST activity accounts for about 80% of the total aST activity of the liver.
3, alT circulation in the body of the half-life longer than AST, the two are about (47 x 10) h and (17 x 5)h, respectively.
4, amino metase as the most sensitive indicators to reflect acute liver cell injury, of which ALT is more sensitive and specific than AST.
5, the mere increase in AST suggests heart muscle or muscle disease, liver disease is less likely.
6, uremia patients AST level can be low, after dialysis increased.
7, the level of amino metastase and the severity of liver damage is often not related, the same amino metastase level to judge the prognosis of acute liver cell injury is not very helpful.
8, the rapid decline of serum amino transferase levels often indicates an improvement in disease, but for outbreak of hepatitis may suggest a poor prognosis.
the rise in serum bilirubin levels accompanied by a decrease in amino metase levels called "bilise isolation", is a large number of necrosis of liver cells, more tips for the disease.
9, hepatitis-induced jaundice patients, serum bilirubin rise often lags behind the rise of amino metastase about a week, so the occurrence of amino metastase decline accompanied by an increase in bilirubin.
10, the division of transaminase increase is conducive to narrowing the scope of etiology diagnosis.
such as a significant increase in levels of amino metase (600IU/L) were found in only a few diseases, the most common causes being acute viral hepatitis, ischemic hepatitis (acute heart failure), acute drug or toxic liver damage.
11, the level of acute bile duct obstruction amino transferase caused by bile duct stones can quickly rise to thousands of IU, and rapidly decrease within 24 to 48 hours after the obstruction of the bile duct is lifted.
12, obstructive jaundice, viral hepatitis combined with AIDS and cirrhosis in three cases, amino metase levels rarely exceed 500 IU/L, alcoholic liver disease rarely exceeds 300 IU/L, muscle disease is usually less than 300IU. the ratio ses/
13, AST and ALT helps to speculate on the causes of liver disease.
the normal value of the adult serum AST and ALT ratio is about 0.8, AST/ALT elevation can be seen in alcoholic liver disease, cirrhosis, ischemic hepatitis, congestive liver disease, acute Buga syndrome, liver artery injury/thrombosis/blocking and whole gastrointestinal nutrition.
viral hepatitis or other liver disease, the AST/ALT ratio can also be significantly increased if liver cell damage worsens and/or affects the mitochondria.
increased aST/ALT ratio in myocardial infarction serum.
14, patients taking biphenyls and their structural analogues also experienced an increase in the AST/ALT ratio.
15, if ALT 300IU/L, AST/ALT 2 prompts alcoholic liver disease, 3 high lying alcoholic liver disease.
16, alcoholic liver disease combined with heart failure, viral hepatitis or drug liver damage (especially acetaminophen), serum amino metase can rise to thousands of IU, but the AST/ALT ratio still increases to typical alcoholic liver disease characteristics.
17, muscle damage caused by vigorous exercise can cause an increase in amino metase, initially AST/ALT can be greater than 3, and then this ratio quickly drops to nearly 1, because AST circulates in the body with a half-life shorter than ALT.
18, AST/ALT ratio can predict chronic hepatitis C cirrhosis, AST/ALT 1 prompts cirrhosis, specificity 94% to 100%, sensitivity 44% to 75%.
Source: Dr. Liver.