- Indications for the study
- The main indicators for liver diseases
- Blood test for malignant neoplasms
- Preparation for the analysis
- Related Videos
The liver is one of the largest glands in the human body. Since there are almost no nerve endings in it, the person does not experience characteristic pains in diseases of the organ. Most pathologies are detected in the late stages. Which blood test shows the liver? This is what will be discussed.
Indications for the study
There are certain signs that indicate liver damage. As a rule, characteristic symptoms appear already in advanced stages, which complicates the treatment of pathology. Biochemistry of blood for liver testing is prescribed in the following case:
- Jaundice of the skin. A typical sign of increased bilirubin levels. Skin yellowness / eye sclera indicates a long-lasting inflammation.
- Increase the size of the organ. Identify the deviation at the initial stage can be using ultrasound. When the organ is strongly enlarged, the abdomen grows on the background of no changes in the total weight.
- Losing weight. For hepatic pathologies, typical nausea and refusal to eat, which leads to weight loss.
- Bitter taste in the mouth. For liver disease, bitterness in the mouth, lined tongue, dense yellow-brown or white coating, cracks on the surface of the tongue are typical.
The main indicators for liver diseases
The condition of the liver allows you to track certain enzymes. It:
- aminotransferase (AST and ALT)
- alkaline phosphatase (AFP)
- glutamate dehydrogenase (Gldg)
- sorbitol dehydrogenase (SDG)
- γ-glutamyltransferase (GGT)
- fructose monophosphate aldolase (FMFA).
This is the main protein produced by the liver tissues. A healthy organ within 24 hours produces 150-250 mg / kg albumin. The norm for an adult is 35-53 g / l. If the study showed a decrease, then the cause may be: liver failure, chronic hepatitis, cirrhosis.
Decrease in albumin level is determined until the appearance of typical symptoms
It is a yellow pigment, formed as a result of the breakdown of hemoglobin. The resulting indirect bilirubin enters the liver, is rendered harmless and is eliminated naturally. Normally, within a day, 250-300 mg (total bilirubin) is formed in the human body. The indicators of direct bilirubin are of diagnostic interest. The norm is not higher than 5.1 μm / l.
Exceeding the permissible values in the blood test indicates the following pathologies:
- inflammation of the gland of a viral origin;
- intoxication with alcohol;
- concrements in the bile ducts.
An increase in the indices of direct / indirect fractions of bilirubin can be caused by:
- toxic / viral inflammation of the gland;
- suppuration, malignant neoplasms in liver tissues;
- cirrhotic organ damage;
Alanine aminotransferase (ALT, ALT)
The norms of ALT depend on the sex of the patient: for men - 10-40 units / l, for women - 12-32 units / liter. An increase in the number of enzymes in the bloodstream can accompany acute hepatitis, obstructive jaundice. The increase in ALT with respect to the permissible is fixed with cirrhosis and against the background of treatment with hepatotoxic drugs.
The increase in enzyme activity in 4-6 times and more indicates a serious liver disease. A deviation is revealed before the appearance of typical symptoms - jaundice, pain syndrome and others - in about 1-4 weeks. After the development of the clinical picture, elevated ALT indices remain not longer than 2 weeks, which is a sign of significant organ damage.
Aspartate aminotransferase (AST, ASAT)
The norm depends on gender: for men - 15-31 units / l, for women - 20-40 units / liter. Increased activity of ACT is fixed in case of death of hepatocytes. In this case, the greater the damage to the organ, the higher the enzyme indices. The increase in quantitative indicators also occurs with acute infectious and toxic hepatitis.
Transaminases - an indicator of a necrosis of hepatocytes
Diagnosis of liver pathologies involves calculating the de Ritis coefficient - the ratio of AST / ALT figures. In norm it is equal to and exceeds the number 1,3. A change in the figures to a lower side of the indicator indicates a lesion of the organ.
Alkaline phosphatase (APF)
The enzyme activity is dependent on sex and age group. In a healthy adult, 30 to 90 units per liter. Increase in AFP occurs in adolescents (up to 400 units / l) and expectant mothers (up to 250 units / l). A significant increase in alkaline phosphatase - 10 times and higher - occurs with the development of obstructive jaundice. With a not so significant excess, one can suspect one of the forms of hepatitis.
Glutamate Dehydrogenase (Gldg)
Normally, a biochemical blood test shows a slight content of Gldg. The reason is that this is one of the hepatic enzymes located inside the cell. And increasing its activity allows you to determine the strength of the organ damage. The increased results indicate the onset of dystrophic processes in the liver tissues, caused by both external and internal factors.
It can be:
- metastases in the liver;
- toxic substances;
- infectious pathologies.
The Schmidt coefficient calculation significantly helps in setting the diagnosis: KS = (AST + ALT) / Gldg. With the development of obstructive jaundice, it is in the range of 5-15, for acute hepatitis the indicator reaches 30, with metastases - about 10.
Sorbitol Dehydrogenase (SDG)
The norm is an indicator not exceeding 0.4 units / liter. If the examination showed an increase in SDG 10-30 times, then this is a clear sign of acute hepatitis.
In a healthy person, the permissible concentration of γ-glutamyltransferase is: in men - 250-1800 nmol / l * s, in the female half - 167-1100 nmol / l * s. An increase in enzyme parameters is possible with the following problems:
- obturative jaundice, cholestasis - for them the growth of the indicator is 10 times or more;
- malignant formations - the activity of the enzyme increases 10-15 times;
- hepatitis in chronic form - 7 times.
In the blood test, the level of γ-glutamyltransferase is used to distinguish between alcohol and viral damage of liver cells
Fructose-monophosphate aldolase (FMFA)
FMFA should be present in the blood only in trace amounts. The definition of this indicator is necessary for diagnosing acute forms of hepatitis. In most cases, it is used to assess the performance of the liver in people whose professional activity is due to direct contact with toxic substances for the liver.
Blood test for malignant neoplasms
Liver cancer and hepatitis is determined by identifying antigens to certain diseases. Markers of hepatitis: A (HAV) - Anti-HAV-IgM, IgM class antibodies to virus A; B (HBV) - Anti-HBs antibodies to HBs-antigen of virus B; C (HCV) - Anti-HCV-total antibodies to C. antigens.
Marker for cancer is the AFM oncomarker. A confirmation of the disease is the result of more than 10 IU. An increase in the indicator may indicate the presence of a malignant neoplasm in the organ itself, the presence of metastasis, embryonic cancer.
At a slight excess, you can suspect:
- renal insufficiency.
Oncology is better indicated by a general clinical analysis in combination with biochemistry
Preparation for the analysis
Biochemistry of blood is prescribed if it is necessary to check the function of the liver. Correctly conducted preparation for delivery of blood will help to get the most accurate results. For two - three days before visiting the laboratory you need to exclude from the menu fatty, fried foods, fast food, sweets, smoked products, cocoa, coffee, marinades.
From the reception of alcoholic beverages must be discarded a week before the analysis. Ethyl affects not only the state of hepatocytes, but also the coagulation factor. On the morning of donating blood, the patient should not smoke. But it is better to give up nicotine 10-12 hours before going to the laboratory.
7 days before the analysis, you must stop taking any medications, including vitamin complexes. If there is no such possibility, then it is necessary to refuse tablets even on the morning of blood donation. A woman should be sure that she is not pregnant. Against the background of gestation, it is possible that the permissible standards are exceeded. And this can not be considered a symptom of a pathological condition.
On the morning of donating blood, you must refrain from doing morning exercises, as increasing physical activity can affect blood counts. The delivery of biomaterial is carried out in the morning, on an empty stomach. The last meal should take place the night before. Supper should be easy.
Blood sampling is performed from the ulnar vein. The procedure is painless, but can be accompanied by a slight dizziness. The interpretation of the analysis should be carried out by the treating doctor, since only a qualified specialist is able to compare all the data obtained and to determine the presence or absence of pathology.