Transaminase catalyzes the interaction between amino acids andKeto acidA class of enzymes that transfer amino groups between.It is widely found in animal and plant tissues and microorganisms, with a high content in myocardium, brain, liver, kidney and other animal tissues as well as mung bean sprouts.
Transaminase is an indispensable "catalyst" in the normal operation of the human liver, a "chemical plant", and a "barometer" of the liver,HepatocyteIt is the main habitat of transaminases.When hepatocytes are inflamed, poisoned or necrotic, they will be damaged, and transaminase will be released into the blood, which will increase the serum transaminase.
Transaminase is a kind of transaminase that catalyzes the transamination reactionα-Amino transferred to aα-Keto acid.
The most important transaminases in human body are glutamic pyruvic transaminase and glutamic oxalic transaminase, which are important indicators of liver function test.
Category Introduction
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There are many kinds of transaminases. Except lysine and threonineα-amino acidAll availableTransaminationEach has its own specific transaminase.Among themGlutamic pyruvic transaminase(GPT) andGlutamic oxaloacetic transaminase(GOT) is the most important.The former catalyzes the transamination between glutamic acid and pyruvate, and the latter catalyzes the transamination between glutamic acid and pyruvateOxaloacetic acidAmmonia transfer between.Transaminase catalyzed reactions are reversible.Transaminases can be divided into three categories according to different substrates: L-α-Amino acid transaminaseω- Amino acid transaminase and D-amino acid transaminase.The cofactor of transaminase isPyridoxal phosphateOr pyridoxamine phosphate, which can be converted to each other in the transamination reaction.
Among the tissues of higher animals, the most active transaminases are glutamic acid: oxaloacetic transaminase (GOT) and glutamic acid: pyruvate transaminase (GPT).
The activity of GOT was the highest in the heart, followed by the liver;GPT is most active in the liver. When the liver cell membrane breaks,Glutamic pyruvic transaminaseGPT is released into the blood, so the enzyme activity in the blood increases significantly.The determination of transaminase activity in blood can be used as a diagnostic indicator in clinical practice.If the determination of GPT activity can diagnose whether the liver function is normal or not, the GPT activity in the serum of patients with acute hepatitis can be significantly higher than that of normal people;The determination of GOT activity is helpful for the diagnosis of heart disease,myocardial infarctionThe activity of GOT in serum showed an increase.
Functions and mechanisms
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Amino acids contain amine (NH2) groups.Ketoacid contains a ketone (=O) group.During transamination, the NH2 group on one molecule exchanges with the=O group on the other molecule.Amino acids become ketoacids, and ketoacids become amino acids.
Most transaminases are protein enzymes.However, it has been found that some transaminating activities of ribosomes are catalyzed by ribozymes (RNA enzymes).Examples are hammerhead ribozymes, VS ribozymes and hairpin ribozymes.
Transaminase needs coenzyme pyridoxal phosphate. When amino acids are converted to ketoacids, they are converted to pyridoxamine in the first stage of the reaction.Enzymatic binding of pyridoxamine in turn with pyruvate, oxaloacetate orα-Ketoglutaric acidReact to produce alanine, aspartic acid or glutamic acid, respectively.Many transamination reactions occur in tissues and are catalyzed by specific transaminases to specific amino/keto acids.The reaction is easy to reverse, and the direction is determined by which reactant is excessive.For example, a specific enzyme comes from one of the reactant pairs;The reaction between glutamic acid and pyruvate makesα-Ketoglutarate and alanine are called glutamate pyruvate transaminase or GPT for short.
Tissue transaminase activity can be studied by incubating homogenate with various amino/keto acid pairs.If the paper chromatography shows that the corresponding new amino acids and ketoacids are formed, the transamination is proved.Reversibility was demonstrated by using complementary ketone/amino acid pairs as starting reactants.After removing the chromatogram from the solvent, treat the chromatogram with ninhydrin to locate the spots.
reference value
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Thirteen normal reference values of liver function
The normal value of glutamic oxaloacetic transaminase (GOT) is 0-37u/L (various liver diseasesmyocardial infarctionEarly stage, necrosis and degeneration of hepatocytes, cirrhosis and liver cancer are abnormally high).
The normal value of GPT is 0-40u/L (hepatitis drug poisoningObstructive jaundice, liver degeneration and sclerosis, cholangitis and cholangioma are abnormally high).
GPT test paper
The normal ratio of glutamic acid to cereal grass is 1.5-2.5:1 (when the ratio is less than 1, it is called inverted, and it is one of the characteristics of chronic hepatitis or cirrhosis)
serum albumin(ALB) The normal value is 35-55g/L (increased total protein and globulin, normal or abnormal albumin indicates cirrhosis and liver damage).
Serum globulin(GRP) The normal value is 25-35g/L (lower albumin and higher globulin indicate cirrhosis, ascites or liver cancer).
The normal value of the white/bulb ratio (A/G) is 1.5-2.5:1 (when the ratio is less than 1, it is called inverted, which is the characteristic of chronic hepatitis or cirrhosis, and some liver cancers can also occur).
People often have various misconceptions about transaminase, thinking that the elevation of transaminase is hepatitis;Abnormal transaminase is infectious;The level of transaminase is directly proportional to the degree of liver cell damage, etc.In fact, in many cases, whether the level of transaminase is normal or not does not represent whether the liver function is good or not.
High transaminaseEarly symptoms?Some people think that high transaminase means hepatitis, and high transaminase can not be determined as viral hepatitis, so it is necessary to have the following three points to determine hepatitis.
1. Symptoms and signs of hepatitis (such as fever, anorexia, nausea, vomiting, fatigue, anorexia, liver swelling and pain, etc.) and clinical diagnosis (such as acute jaundice type, chronic persistent type, etc.).
2. Serum transaminase increased;Etiological diagnosis (anti hepatitis A antibody is type A, and hepatitis B virus surface antigen, e antigen and core antibody positive is type B).
3. The simple transaminase of some people is on the high side, which does not exclude the interference caused by excessive drinking, strenuous exercise, night shift, cold or taking some drugs before the test.
Liver damage
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Aspartate transaminase
There are manyAminotransferaseIn clinic, there are two kinds of transaminases used to test liver function through blood sampling test, one is calledAlanine transaminase（ALT）；The other is calledAspartate transaminase（AST）。ALT and AST mainly exist in liver cells, and other organs such as kidneymyocardiumThe pancreas, muscle, spleen, gallbladder and lung also contain a certain amount of ALT and AST.ALT mainly exists in the cytoplasm, and AST mainly exists in the mitochondria of the cytoplasm.When cells are damaged (such as hepatitismyocarditis、pancreatitisALT first enters the blood. When cells are seriously damaged and mitochondria are endangered, AST will also enter the blood.In addition,innutritionAlcoholism, the use of certain drugs, fever and other conditions can make transaminase slightly increased.Under physiological conditions, there are also variations in serum transaminase, such as intense activity, physical exercise, and during menstruation, transaminase can also be temporarily elevated.
Because ALT and AST mainly exist in hepatocytes, when they are significantly elevated, it often indicates liver injury.Of course, there are many reasons for liver injury, such asLiver trauma, acute and chronic inflammation of various livers, fatty liver, cirrhosis and liver cancer.Therefore, when the transaminase is found to be elevated, we should not panic or take it lightly. We should further investigate the cause.
It is generally believed that if ALT serum value exceeds 2-3 times of normal upper limit and lasts for more than two weeks, it indicates thatHepatobiliary diseasesIf possible, alcoholism, myocarditis, chemical poisoning, parasitic diseases, etc. must be excluded;If the measured value exceeds the normal upper limit by 20 times, it indicates that there is hepatobiliary disease;If there is positive at this timehepatitis virusMarkers can be used to diagnose hepatitis.The normal upper limit of ALT is 40 units, 2.5 times is 100 units, and 20 times is 800 units.
Acute hepatitisALT increased significantly, mostly more than 500 units, even more than 1000 units, and sometimes AST also increased significantly.Regardless of acute hepatitis, chronic hepatitis or cirrhosis, if the AST increase is equal to or greater than ALT, that is, AST/ALT ≥ 1, it often indicates thatHepatocyte injurySerious, relatively serious condition.ALT in chronic hepatitis increased slightly, mostly below 300 units.
High transaminase
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1. The level of transaminase is normal, and liver damage persists.Seen in some hepatitis patients, such as the so-called chronichepatitis B virusCarriers, these people have always been positive for hepatitis B virus indicators, but transaminase has never been elevated, some have had fibrosis, even cirrhosis and liver cancer;There are many acute andChronic hepatitis CThe patient has a similar situation.
2. The level of transaminase is very high, but it is only a temporary liver damage, which will not have a great impact on liver function, and the consequences are not very serious, such as taking a drug with strong toxicity to the liver.
threejaundiceVery deep, transaminase is not high, even normal.
4. Although some patients with liver cirrhosis and liver cancer have advanced liver disease and poor liver function, transaminase is normal.
5. Transaminase is abnormal for a long time, but the level is not high.This is more common in patients with chronic hepatitis, including chronic hepatitis B and CAutoimmune hepatitisAlcoholic hepatitis after long-term heavy drinking.
6. Finally, there is a kind of modern civilization disease, namely fatty liver, which is characterized by a slight increase in transaminase, generally not more than 100 units. Such people are generally overweight, or severely overweight.
In addition to the symptoms of transaminases mentioned above, there are also two kinds of transaminases, namely alanyl aminotransferase (ALT) and aspartate aminotransferase (ASTAlcoholic hepatitis。
matters needing attention
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taboo
Hepatitis B patientsThe elevation of transaminase is a common clinical phenomenon. Most patients with liver diseases compare transaminase with liver function. When they mention liver function, they immediately think about the level of transaminase.In fact, there is a certain mistake in this idea. Transaminase is just an index commonly used in clinical examination of liver function. Whether transaminase is normal or not does not represent the quality of liver function. The level of transaminase is not proportional to the state of liver function.
In the process of treatment, patients with hepatitis B should find out the cause of their elevated transaminase and treat them symptomatically according to the cause. In addition, when the transaminase of patients with hepatitis B is elevated, patients should also pay attention to normal diet and health care. What do patients with hepatitis B eat high in transaminase?What is good for hepatitis B patients with high transaminase?What are the daily taboos?
The following taboos should be paid attention to in the life of hepatitis B patients with elevated transaminase:
1. Avoid spicy
Spicy food is easy to cause the generation of dampness and heat in the digestive tract, the mixture of dampness and heat, the imbalance of liver and gallbladder qi, and the weakening of function.Therefore, patients with hepatitis B should avoid eating spicy products when transaminase is elevated.
2. No smoking
Smoke contains a variety of toxic substances, which can damage the liver function and inhibit the regeneration and repair of liver cells.Therefore, hepatitis B patients with elevated transaminase must quit smoking.
3. Alcohol prohibition
Patients with hepatitis B should not drink when transaminase is elevated: 90% of alcohol should be metabolized in the liver, and alcohol can make liver cells normalEnzyme systemIt is disturbed and damaged, so it directly damages hepatocytes and causes necrosis of hepatocytes.Patients with acute or chronic active hepatitis, even if a small amount of alcohol, will make the condition repeated or changed.
4. Avoid eating processed food
Hepatitis B patients with elevated transaminase should eat less canned or bottled drinks and food.This is because canned and bottled drinks and foods often contain preservatives, which are more or less toxic to the liver.
5. Do not abuse hormones and antibiotics
There are three kinds of drugs that are toxic. Drugs are harmful to the liver and kidney. The elevation of transaminase in patients with hepatitis B must be used rationally under the correct guidance of doctors.
6. Avoid misusing supplements
A balanced diet is the basic condition for keeping healthy. If the transaminase in patients with hepatitis B is elevated,Dysfunction of viscera, breaking the balance will affect health.
7. Avoid irregular life
"Three points for treatment and seven points for nutrition", so for hepatitis B patients with elevated transaminase, adequate sleep, reasonable nutrition, regular life, morning exercises every day, and a combination of work and rest are very important.
8. Avoid anger
Qi hurts the liver.[2]
Diet attention
stayLiver function testIn the test, high transaminase indicates that liver function is damaged.Because transaminase mainly exists in hepatocytes, when hepatocytes are poisoned by toxic substances, denaturation, necrosis and poisoning occur, transaminase will be released into the blood, leading to the elevation of serum transaminase.stayHigh transaminaseWe should pay attention to reasonable diet in the following two points:
1. Eat more fungus food, such as agaric, mushroom, mushroom, etc., to improve immunity.Patients with high transaminase should also eat more high protein food to promote the repair and regeneration of liver cells.Fish is rich in protein and easy to digest, which is suitable for patients with high transaminase.
2. Other causes
Elevated ALT only indicates that the liver may be damaged.In addition to hepatitis, many other diseases can cause the increase of transaminase.The common reasons for the elevation of transaminase are as follows:
2) In addition to the liver, other organs and tissues in the body also contain this enzyme.
3) Because transaminase is excreted from the bile duct, if there are bile duct, gallbladder and pancreatic diseases, bile duct obstruction can also increase transaminase.
4) Drug induced or toxic liver damage.For example, when you are sick, you take drugs that can damage your liver, such as erythromycin, tetracycline, sleeping pills, antipyretic and analgesic drugs, contraceptives, and Chinese medicines such as Pinellia ternata, areca, indigo naturalis.After discontinuing these drugs, transaminase levels will soon return to normal.
5) Normalgestation、Toxemia gravidarumAcute fatty liver in pregnancy is also a common cause of elevated transaminase.
6) For some people who don't seem seriously ill, it may be caused by long-term drinkingAlcoholic liver, or unreasonable diet structure leads to fatty liver, resulting in high transaminase.
In addition, the transaminase level of healthy people may temporarily exceed the normal range.May temporarily increase transaminase.If you worked overtime the night before the transaminase examination, did not sleep well, or ate fried food at breakfast before the physical examination, the examination results may exceed the normal range.A person has just run a few laps on the playground, and immediately checks his transaminase level, the result may also be higher than the normal range.
According to《Health Times》It is an indicator of liver function.When hepatocytes are inflamed, necrotic, poisoned, and damaged, transaminase will be released into the blood, making serum transaminase rise.In general, the transaminase checked in physical examination is alanine transaminase (ALT). 1% of liver cells are damaged, which can double the concentration of ALT in blood;ALT level can monitor whether the liver is damaged sensitively.Therefore, many people mistakenly believe that as long as the transaminase is high, it is hepatitis.In fact, in addition to hepatitis, many other diseases may also cause the elevation of transaminase.
1. Endocrine dysfunction: such as adrenal cortex dysfunctionHyperthyroidismIt can damage the liver and increase ALT.
2. SomeAutoimmune disease:asSystemic lupus erythematosusIf liver is involved, hepatocytes will become necrotic and ALT will rise.
3. Infection with certain bacteria: infection with parasites or myocarditis, myocardial infarction, etc. may increase transaminase.
4. Undernutrition: The diet structure is unreasonable, such as low protein diet, especially when the food lacks cystinevitamin EIt can also increase ALT.
sixBiliary obstruction: Extrahepatic biliary obstruction such as gallstones, inflammation, parasites, etc., and intrahepatic biliary obstruction such as cirrhosis, etc., can cause necrosis or increased permeability of hepatocytes and increase ALT.
7. Drug side effects: such aserythromycinSleeping pills, antipyretic analgesics, contraceptive creams and Pinellia ternataBetel nut, Indigo Naturalis and other traditional Chinese medicines can increase ALT.When these drugs are stopped, transaminase levels will soon return to normal.
8. Others: other infectious diseases, such as pneumonia, typhoid fever, tuberculosisInfectious mononucleosisEtc.
There are many reasons for the high ratio of GPT, so further inspection should be carried out to find out the cause and take effective measures for the situation of GPT increase.Avoid random suspicion to avoid unnecessary psychological burden.Therefore, it is necessary to judge whether the elevation of transaminase caused by liver damage is due to other liver related examinations.
Many hepatitis patients hope to reduce the transaminase index and restore the normal liver function, so they have tried all kinds of methods and also taken many drugs to protect the liver and reduce enzymes, but few of them are effective.
Clinical significance
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The increase of transaminase often indicates that the liver is damaged, and the clinical significance of the increase of transaminase in different degrees is different. Director Nie will analyze and explain the clinical significance of the increase of transaminase:
The clinical significance of slightly increased transaminase. A variety of diseases will cause slightly increased transaminase, such asToxic shock, influenza, rheumatic myocarditis, pulmonary tuberculosis, stagnant liver, reticulocytosis, acute pancreatitis, cholecystitis, rheumatic active heart disease, nutritional liver disease, advanced schistosomiasis, prostatic hypertrophy, polycystic liver, antimony treatment poisoning, etc;
The clinical significance of moderate elevation of transaminase, which mostly indicates hepatitis, such as chronic hepatitis active phase, cirrhosis compensatory phase, obstructive jaundice, persistent hepatitis, diffuse liver cancerAcute rheumatic fever, myocardial infarction, etc;
The clinical significance of significant increase of transaminase. Acute infectious hepatitis and serum hepatitis will cause significant increase of transaminase. At this time, timely treatment should be carried out to prevent the disease from becoming serious.[3]
harm
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Transaminases mainly exist in liver cells, including glutamic pyruvic transaminase and glutamic oxaloacetic transaminase. When liver cells become inflamed and necrotic, the release of transaminase into the blood will cause the increase of transaminase concentration.Therefore, high transaminase generally indicates liver damage.High transaminase is common in patients with liver disease, and the harm of high transaminase in different patients with liver disease is also different.
If the transaminase is elevated due to viral hepatitis (such as hepatitis B, hepatitis A, hepatitis C, etc.), the high transaminase usually indicates that the liver has inflammatory activity and is accompanied by liver injury, and antiviral treatment should be carried out as soon as possible.asHigh transaminaseFailure to receive timely treatment may lead to continuous liver damage, which may lead to cirrhosis.In China, patients with viral hepatitis are the most vulnerable to high transaminase levels.
If the transaminase is elevated due to cirrhosis or liver cancer, it indicates that the patient's condition is deteriorating or unstable. At the same time, cirrhosis and liver cancer are prone to complications, and if not treated in time, life may be endangered.
If alcoholic liver and fatty liver cause the elevation of transaminase, and no treatment is given, it will also lead to continuous liver damage and eventually form cirrhosis and liver cancer.
Reduction method
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There are many ways to reduce transaminase, but we should not blindly use the means to reduce transaminase.It is necessary to make diagnosis according to the patient's physical quality, condition and disease type, and select the best treatment plan and drugs to achieve the goal of complete cure.
1. TreatmentHigh glutamic pyruvic transaminaseChinese medicine and extracts of its effective components are mainly used for the treatment of acne.The above various Chinese medicine ingredients have the effects of benefiting the liver, nourishing the kidney, detoxifying and removing dampness, and can be used to treat variousChronic liver diseaseFor patients with elevated transaminase, transaminase can be effectively controlled as long as the patient correctly uses the enzyme lowering drugs, and the effect of enzyme lowering treatment is lasting and stable.In addition, the control of enzyme lowering of traditional Chinese medicine in drug withdrawal rebound is much better than that of western medicine.
2. The treatment of high alanine aminotransferase by simply reducing enzyme is only a symptom. Therefore, while protecting the liver and reducing enzyme, we must take "root cause" measures according to the cause.For example, the treatment of hepatitis B causes a high transaminase, and the enzyme reduction must be accompanied by antiviral and immunomodulation treatment, so that the final therapeutic goal can be achieved by treating both the symptoms and the root causes.
Don't blindly use drugs that reduce transaminase. While reducing transaminase, first see what causes high transaminase.
High transaminase is not necessarily hepatitis.The elevation of transaminase can only be used as a reference index for liver damage.The factors that cause the elevation of transaminase are very common.
Generally speaking, the high transaminase caused by extrahepatic diseases is mostly a slight increase. If the serum transaminase value exceeds 2.5 times the normal upper limit (40 units) and lasts for more than half a month, there is a high possibility of liver and gallbladder diseases;If the test result exceeds the normal upper limit by 20 times, it can be basically concluded that it is caused by liver and gallbladder diseases, and mainly by liver cell damage, but it cannot be arbitrarily identified as hepatitis.This is because what we call hepatitis usually refers to viral hepatitis caused by hepatotropic virus, including type A, B, C, D, E, etc.Caused by bacteria, parasites or alcohol abuseLiver abscess, liver fluke, liver cysticercosis, liver tuberculosisAlcoholic liver diseaseIt can also cause liver damage and elevation of transaminase.In addition, transaminase isBiliary systemWhen excreted into the small intestine, when bile duct obstruction is caused by various reasons, the excretion of transaminase will be affected, and the transaminase in the blood will be increased, which is mainly seen in cholelithiasis, biliary ascariasisPeriampullary carcinoma, pancreatic head cancer, etc.If the disease with elevated transaminase can be diagnosed, the primary disease can be treated simultaneously with the treatment of elevated transaminase, so as to achieve the effect of treating both symptoms and root causes.
There are many reasons for the increase of transaminase. To solve the problem of high transaminase for a long time, first find out the reason, and then apply the right medicine to the case.
① Diseases of the liver itself, especially various types of viral hepatitis, cirrhosis, liver abscess, liver tuberculosis, liver cancer, fatty liver, etc., can cause the elevation of transaminase to varying degrees.
② In addition to liver, other internal organs such as heart, kidney, lung, brain, testis and muscle also contain this enzyme.
③ Because transaminase is excreted from the bile duct, if there are bile duct, gallbladder and pancreatic diseases, bile duct obstruction can also increase transaminase.
④ Drug induced or toxic liver damage.
⑤ Normal pregnancy, pregnancy poisoning, and acute fatty liver in pregnancy are also common causes of elevated transaminase.In addition, acute exercise can also cause the elevation of transaminase.Chronic transaminase elevation is a special temporary diagnosis in clinical practice, and it is also the only clinical manifestation of many patients with non viral hepatitis and liver disease. Most of them can determine the etiology of liver disease through medical history, physical examination and a series of tests;However, some abnormal liver function cannot be explained by routine examination, which requires further liver biopsy to thoroughly understand the cause.Only by finding out which of the above reasons is responsible for the elevation of transaminase, can we trace the root cause and prescribe the right medicine to the case.
medicine
High transaminase is more common in clinical examination. There are many reasons for high transaminase, some of which are non pathological and some are pathological. For high transaminase caused by non pathological reasons, drugs are generally not required;The high transaminase caused by some pathological reasons can be treated by reducing the enzyme.
Schisandra Chinensis and diphenyl diester can enhance the detoxification function of the liver, and reduce enzymes strongly and quickly.After 2-3 weeks of continuous administration, 90% of alanine aminotransferase can decrease, 80% can return to normal, but it can rise again after half a month to March after drug withdrawal.And it can reduce the dose.One to two tablets for adults, three times a day, and 6-10 pills.Three times a day, if the transaminase returns to normal, you can continue to take it for 3-6 months in reduced doses to prevent rebound.The drug has few side effects, with nausea, epigastric discomfort and insomnia occasionally.
2. Yiganling
It can reduce enzyme, improve liver metabolism and stabilize liver cell function.The effective rate of reducing enzyme is 67.2%, which can also improve appetite, reduce fatigue and edema.Dosage: 4 pills, 3 times a day.There are alsoCompound YiganlingThe curative effect is better than the former, 3 to 4 tablets each time, 3 times a day.
There are many drugs previously used to protect liver and reduce enzymes, but transaminaseGao YaoTake what medicine?Director Jiang pointed out that patients with high transaminase should first find out the cause and treat symptomatically to achieve a good therapeutic effect:
1. Temporary high transaminase, such as strenuous exercise and excessive fatigue, may be caused by taking some drugs such as erythromycin, sleeping pills, antipyretic analgesics, etc. Under these circumstances, it is not necessary to take drugs. After removing the cause, go to the hospital for examination, and the transaminase will return to normal;
2. Malnutrition and unreasonable diet structure will cause high transaminase. At this time, eat more high protein foods, adjust diet, and transaminase will soon return to normal;
3. What medicine should I take for the high transaminase caused by other reasons?On the one hand, it is the most important and common cause of high transaminase, such as liver disease, biliary obstruction, typhoid fever, autoimmune diseases, etc.
Healthy people
In addition, the transaminase level of healthy people may temporarily exceed the normal range.Because transaminase is very sensitive, the level of transaminase in healthy people may fluctuate at different times of the day.Therefore, high transaminase does not necessarily require medication.If these conditions lead to the elevation of transaminase, it is generally unnecessary to reduce the enzyme treatment.As long as you have a good rest, and check again after a period of time, you will find that the transaminase level has returned to normal.
Commonly used traditional Chinese medicine preparations
Traditional Chinese medicine preparation has obvious protective effect on liver cells, which can reduce inflammation and cell degeneration, reduce the activity of transaminase in liver cells, resist liver cell necrosis, and promote liver cell regeneration.There are many kinds of traditional Chinese medicine enzyme reducing agents, mainly including schisandra chinensis, sophora root, liquorice, oleanolic acid, silymarin, and sedum sarmentosum. The common feature is that the speed of reducing serum transaminase is extremely fast, the efficacy is immediate, almost no obvious side effects, can be used for a long time, and the price is very cheap, which is absolutely suitable for people to use.The disadvantage is that it can only be used as an auxiliary drug for the treatment of hepatitis, and its enzyme lowering effect is outstanding, but its antiviral effect is still unsatisfactory.Therefore, they also belong to the "temporary" products, and the "root cause" is not yet ready for fire.
oneDiphenyl diester: The drug is syntheticSchisandrin CIt can promote the regeneration of liver cells, increase the detoxification ability of liver, promote the production of liver glycogen, and protect mitochondrialysosomeFunction, the speed of reducing transaminase is the fastest.It is mainly used for chronic persistent hepatitis, not for acute or severe hepatitis.The usage isBiphenyl diester dropping pills5~10 capsules (7.5~15μg) , 3 times a day for 3 months, and then gradually reduce the dosage.Biphenyl diester tabletTake 1-2 tablets (25-50) orally each timeμg) , 3 times a day, 6 months as a course of treatment.
twoQianglining: The drug is glycyrrhizin monoamine andL-amino acidMixed composition, with anti-inflammatory, antiallergic, immunosuppressive and anti fibrotic effects, as well as inducing the production of interferon.So it can reduce the level of transaminase, improve symptoms, and reduce the level of jaundice, but it has no significant impact on the clearance of hepatitis virus.Use 60~100ml once a day, add 5% or 10%Glucose Injection250~500ml intravenous drip, 1~3 for a course of treatment.
threeGanlixin: Ganlixin mainly contains diammonium glycyrrhizinate, which is an improved product of Qiangqianning. Its enzyme lowering effect is better than Qiangqianning, and its adverse reactions are less than Qiangqianning.Usage: 30ml daily, diluted and drip.The oral dosage is 450 mg per day, which is taken three times. The precautions are the same as those of Qiangli Ning.
fourSilymarin: A new flavonoid glycoside extracted from the degreased seeds of this strain of thistle has a strong liver protective effect.It can restore the function of liver cells, reduce steatosis, and inhibit the increase of alanine aminotransferase.be used forAcute and chronic hepatitis、Early cirrhosis、Toxic hepatitisTreatment.Silybin meglumine tablets, 50mg/tablet, 200mg/day, twice orally.Compound Yiganling Tablets(Compound Silymarin Tablets) Aqueous thistle and Schisandra chinensis, 2 tablets/time, 3 times/day.
5. Schisandra preparation: It has anti free radical effect, can stabilize liver cell membrane, inhibit the release of aminotransferase in mitochondria, and promote liver cell regeneration.Single schisandra has the effect of reducing enzyme, but it is easy to rebound after stopping the drug.
sixXiaochaihu SoupPreparation: This preparation has many effects in the treatment of hepatitis.In addition to reducing enzymes, it can also promote liver cell regeneration, induce endogenous interferon, and enhancemacrophageVitality andNatural killer cellsTo inhibit and eliminate hepatitis virus.
sevenQingkailing: forAngong Niuhuang WanThe modified compound injection has multiple effects of clearing away heat, detoxification, sedation, and tranquilization.In addition, it can repair damaged hepatocytes.It can also reduce enzyme and yellow, suitable for acute hepatitisSubacute severe hepatitisThe effect of intravenous drip is better than that of intramuscular injection.
Others: traditional Chinese medicine preparations with enzyme reducing effect also include Sedum sarmentosum, Soya bean root, Salvia miltiorrhiza, Tianjihuang, Coriolus versicolor polysaccharidePolyporus umbellatus polysaccharideLycium barbarum polysaccharide, baicalin, etc. have good effects.It should be noted that you must follow the doctor's advice when taking medicine. Generally, you can choose one or two single or combined treatments to avoid increasing the burden on the liver.
infectivity
The infectivity of hepatitis B patients mainly depends on the degree of replication (reproduction) of hepatitis B virus in liver cells.If the virus propagates actively, a large amount of virus will be released into the blood, and the hepatitis B virus e antigen in the serum will be detectedpositiveIts blood is highly infectious;Ifhepatitis B virusE antibody is positive, indicating less reproduction and lower blood infectivity.
In fact, the increase of transaminase only reflects the inflammatory reaction in the liver, and the real infectious period is the early stage of hepatitis virus infection (clinically referred to as the incubation period). At this time, there is no symptom, no inflammatory reaction in the liver, and the transaminase is normal. Once the liver has inflammatory reaction, when the transaminase increases, the virus titer in the blood tends to decline quickly, and the infectivity is significantly weakened,The change of virus in all types of viral hepatitis has this rule, so it is a misunderstanding to think that the increase of transaminase means that the patient is infectious.
HBV is mainly transmitted through blood and blood products, mother to child transmission, and sexual contact.Perinatal (perinatal) transmission is the main mode of mother to child transmission, and most of them are exposed to the blood of HBV positive mothers during delivery.Sexual contact with HBV positive persons, especially those with multiple sexual partners, significantly increases the risk of HBV infection.Blood transmission mostly occurred in the 1980s due to poor sanitary conditions in China, no use of disposable syringes, and no examination of hbsag in blood donation.120 million yuan in ChinaHepatitis B carriersAbout one third of them were transmitted by blood transfusion in the 1980s.
Daily work or life contact, such as working in the same office (including sharing office supplies such as computers), shaking hands, hugging, sharing a dormitory, dining in the same restaurant, sharing toilets and other contacts without blood exposure, will not infect HBV.So HBV is not terrible.
Particular attention
world health organizationIt has been proved that hepatitis B is notInfectious diseases of digestive tract。In viral hepatitis, only hepatitis A and hepatitis E are infectious diseases of digestive tract.Eating at the same table, kissing, etc. will not cause the spread of hepatitis B.At the same time, Japan, the United States, Hong Kong, Macao, Taiwan and other regions with a higher proportion of hepatitis B carriers also did not check hepatitis B serological indicators in routine physical examinations such as entry and enrollment.[1]
