Biochemical ntsuam ntawm ntshav. ALT thiab AST: kev txiav txim siab ntawm cov yeeb yam

Alanine aminotransferase, los yog ALT, thiab aspartate aminotransferase, los yog AST, yog cov enzymes uas muaj nyob rau hauv lub hlwb ntawm lub cev thiab uas koom rau hauv cov amino acid txauv. Lawv tsuas yog nyob rau hauv cov hlwb ntawm cov nqaij ntawm lub cev, thiab nkag rau cov ntshav thaum lub cell disintegrates nrog kev raug mob los yog pathologies.

Hom mob

Cov ntsiab lus ntev li ntawm ALT qhia tau hais tias kev loj hlob ntawm cov khoom hauv lub cev, hauv cov hlwb uas muaj nws coob tshaj plaws. Qhov ua rau muaj tus kabmob cineinin aminotransferase yog tus kabmob pathologies. Hnov tsis xis nyob thiab hnov mob siab heev nyob rau hauv txoj kev hypochondrium, raws plab, icteric staining ntawm daim tawv nqaij thiab mucous daim nyias nyias, flatulence, belching ntsim - cov no yog cov cim qhia ntawm ib qho kev nce hauv ALT. Thaum ua tiav cov ntshav mus kuaj ALT thiab AST, nce qib ntawm cov tshuaj hu ua bilirubin ntxiv thaum muaj kev tsim kab mob siab. Ntau zaus qhov nce hauv cov ntsiab lus ntawm ALT qhia tias qhov tshwm sim ntawm lwm cov kab mob. Qhov concentration ntawm ALT yog ncaj qha nyob ntawm seb qhov teeb meem loj ntawm kev mob ntsws.

Necrotic cov txheej txheem nyob rau hauv lub plawv mob ua rau cov kev tso tawm ntawm cov enzymes no rau hauv cov ntshav. Lawv cov ntsiab lus muaj zog hauv cov ntshav dej kuj qhia tau tias qhov kev loj hlob ntawm lwm cov cardiopathologies: tsis muaj txhij txhua, mob ntawm lub plawv mob. Tsis tas li ntawd, yog vim li cas thiaj li yuav ua rau cov ntshav qab zib tsawg zuj zus tuaj yeem ua rau raug mob hauv lub cev, uas muaj kev puas tsuaj rau cov leeg nqaij, thiab pancreatitis.

Biochemical tsom ntawm cov ntshav ntawm ALT thiab AST tuaj yeem tham txog qhov pathology ntawm lub siab, txiav, plawv. Nrog cardioinfarction, cov concentration ntawm AST nce ntau zaus, thiab ALT - me ntsis.

Qhov kev ntsuas rau kev kho mob

Cov kabmob ntawm tib neeg lub cev muaj ntau npaum li cas ntawm ALT thiab AST enzymes, yog li kev nce hauv qhov tshwj xeeb ntawm ib qho enzyme qhia tau hais tias lub yeej ntawm ib qho kev hauv nruab nrog:

• ALT tsuas pom muaj nyob rau hauv siab, lub plawv, lub raum thiab cov kab mob pancreatic. Thaum muaj kev puas tsuaj ntawm cov kabmob no, ntau ALT raug tso tawm rau hauv cov ntshav. Tom qab ntawd, kom paub tseeb tias qhov mob, nws yog qhov yuav tsum tau kawm tshwj xeeb rau cheeb tsam amine nitrin.

• ACT feem ntau muaj nyob rau hauv cov hlab ntsha, leeg, lub siab thiab lub plawv hauv hlwb, thiab hauv cov xov tooj me hauv hlwb ntawm cov txiav, cov ntsaws ntsaws thiab kab mob hauv lub plab. Yog li, qhov no, kev tshawb fawb ntawm aspartate aminotransferase yog tsim nyog.

Kev soj ntsuam ntawm ntshav ALT thiab AST (cim seev cev) qhia tias lub xeev muaj kabmob. Ua rau lawv qhia tias puas tsuaj rau cov nqaij ntawm cov kabmob uas cov enzymes nyob ntawd. Thiab, raws li, qhov txo qhia tau hais tias ib tug kho. Ib qho kev nce me ntsis hauv ALT hauv thawj peb lub hlis cev xeeb tub yog qhov txaus siab, tiam sis nws yuav tsum rov kuaj cov ntshav rau aminotransferases kom tshem tawm daim siab puas.

Biochemical tsom xam ntawm cov ntshav (ntsuas ntawm ALT, AST) yog muab thaum tus neeg phem ntawd kardioinfarkt, lawv yog ib tug thaum ntxov sau npe nyob rau ntawm no tseem ceeb heev tus kab mob. Decoding ntawm AST nyob rau hauv biochemical tsom ua rau nws tau mus tshawb nrhiav thiab soj ntsuam nyob rau hauv lub puab ntawm lwm yam kev hloov hauv lub siab nqaij, daim siab kab mob thiab cov kab mob ntawm cov leeg nqaij.

Kev npaj rau kev ntshav kuaj rau txoj kev tshawb no

Ntshav rau qhov kev ntsuam xyuas biochemical yog noj thaum sawv ntxov nyob rau ntawm lub plab khoob ntawm cov leeg. Thaum lub sij hawm ntawm qhov kev ntsuam xyuas, nws yuav tsum yog 8 xuab moos. Los ntawm qhov kawg siv cov zaub mov. Rau 24 xuab moos. Ua ntej yuav noj cov ntshav, haus dej cawv thiab cov khoom noj uas rog thiab rog yuav tsis pub. Nws raug pom zoo los txo cov kev lis kev cai. Tam sim ntawd tom qab lub ultrasound, radiographic, fluorography, colonoscopy los yog physiotherapy cov txheej txheem, ntshav tseem tsis pom zoo rau kev ntsuam xyuas, txwv tsis pub lub cim ntawm biochemistry yuav distorted. Rau 1-2 lub lis piam. Ua ntej txoj kev kawm biochemical koj yuav tsum tsis txhob noj tshuaj. Thaum tsis tau tus mob no, tau sau ib daim ntawv los ntawm tus kws kho mob kev soj ntsuam txog kev siv cov tshuaj thiab lawv cov tshuaj. Nyob rau biochemical tsom xam ntawm cov ntshav (transcript ntawm ALT, AST) yuav los ntawm hnyav fiznagruzki, raws li zoo raws li cov kev siv cawv thiab tuav hemolysis.

Decoding ntawm qhov kev kuaj ntshav - ALT, AST: feem ntau

Qhov ntau npaum li cas ntawm cov enzymes no yuav tsum muaj nyob rau hauv cov ntshav ntawm ib tug neeg noj qab nyob zoo? Yog nqus tau ntshav Science News for KIDS (transcript ALT, AST), tus nqi rau cov poj niam - xws li los ntawm 31 mus 35 units ib liter ntawm cov ntshav. Rau qhov sib deev, qhov ntsuas no txawv me ntsis. Tej ALT nyob rau hauv cov ntshav ntawm cov txiv neej (Biochemistry seev suab) - los ntawm 41 mus 50 U / L. Hauv cov me nyuam yug tshiab (txog li 1 lub hlis) qhov kev nyeem ntawv sib raug tseem ceeb rau 75 units, txij li 2 txog 12 hlis. - tsis pub ntau tshaj 60 units, thiab los ntawm ib xyoos mus rau 14 xyoo - tsawg dua 45 units. Ntshav tsom xam (seev suab ALT, AST) nrog ib tug high school cov hais tej zaum yuav qhia cirrhotic raug mob los yog mob siab o, txhaws los yog hemolytic daj ntseg, lwm yam kabmob siab (thiab neoplasms r. H), angina nyob rau hauv qaug dab peg ntev, mob rheumatic carditis, myopathy, kua tsib stasis , Thromboembolic pulmonary artery disease thiab mob pancreatitis. ALT thiab AST ntshav kuaj (lo lus cim) nrog rau kev nce qib yog pom nrog kev raug mob, kev pabcuam ntsiav tshuaj los yog nrog angiocardiography. Qhov nce AST tshwm sim 20-50 zaug qee zaus qhia tau hais tias muaj kab mob hepatic pathology nrog necrosis, thiab kab mob siab ntawm tus kab mob viral etiology. Qhov nce hauv AST cov ntsiab lus hauv 2-5 zaug tuaj yeem sib tham txog cov kab mob uas muaj hemolysis, cov leeg mob, mob pancreatitis thiab gangrene. Ntawm dystrophic phenomena nyob rau hauv cov leeg thiab dermatomyositis, muaj 8-fold nce hauv AST.

Ratis coefficient

Yuav kom paub tseeb cov lus teb, ntshav ntsuas ALT thiab AST (seev suab) qhia qhov sib txawv ntawm cov nqi xa tuaj. Qhov no piv qhia tau tias tsib Ritis coefficient, tau ua ib qhov kev tshawb nrhiav ntshav qab zib. Nyob rau hauv rooj plaub thaum tus naj npawb siab tshaj qhov txawv (N = 1,3), qhov no qhia tau hais tias muaj cov cardioinfarction, thiab thaum nws qis dua qis qis - txog kab mob siab kis kab mob.

Txij li thaum aminotransferases muaj cov ntaub so ntswg hauv zos, kev txhais cov kev kuaj ntshav ntawm AST pom tias lub ncauj ntawm lub myocardium, thiab ALT - qhov pathology ntawm daim siab, uas yog, muaj qhov tawg disintegration:

• Thaum muaj ntau tshaj 2 zaug lossis ntau zaus, lub plawv nres tau txiav txim siab hauv plawv.

• Kev kuaj ntshav ntawm ALT thiab AST (lo lus cim) qhia tau hais tias muaj kev cuam tshuam loj heev - qhov no yog qhov pov thawj ntawm kab mob siab hom kab mob nyob rau hauv lub sijhawm tsim kab mob.

• Nrog rau txo tus aminotransferase, tsis muaj pyridoxine hauv lub cev. Nws yuav tsum muaj diffodiagnosis nrog cev xeeb tub.

Tactics

Feem ntau, nyob rau hauv lub ntshiab transferase muaj nyob rau hauv me me tagnrho. Tag nrho cov kev xaiv kom nce qib ntawm aminotransferase yuav tsum rau kev tshawb nrhiav.

Pib nrog, rov kuaj biochemical ntshav (lo lus ALT, AST) yuav tsum tau ua. Kev rov kuaj dua ntawm qee cov tib neeg (hloov khoom) nyob rau hauv ib feem peb ntawm cov neeg mob qhia tau hais tias muaj qee theem.

Tom ntej, koj yuav tsum ua tib zoo sau cov anamnesis thiab ua tiav kev xeem.

Lub luag haujlwm ntawm anamnesis ua tiav cov ntawv sau tseg

Anamnesis muaj cov ncauj lus qhia txog kev noj tshuaj, kev tso ntshav, kev muaj mob rau hauv lub cev, kab mob hauv lub siab, mob plawv, los yog muaj cov txheej txheem cirrhotic hauv nws, mob plab, mob cancer, ntshav qab zib, rog los sis, hloov dua siab tshiab.

Tsev Neeg lub siab tus kab mob - yog haus dej haus cawv nyob tos, Wilson tus kab mob , thiab lwm tus neeg.

Yog tias ALT thiab AST cov ntshav kuaj (lo lus hais los saum toj) pom muaj tsawg tshaj li ob zaug, nws yuav tsum tau saib xyuas thiab kuaj 2 xuab moos. Xws li cov tswv yim zoo tshaj plaws rau cov neeg mob.

Kev ntsuam xyuas ntshav ALT thiab AST - seev suab nrog qee cov kab mob

Ib qho qis me ntsis tuaj yeem yog qhov qhia tias tsis yog-daim ntawv tsis muaj mob rog, nrog rau "rog daim siab", tsis yog-ntawv steatohepatosis, kab mob siab kis kab mob hauv daim ntawv ntev.

Kab mob nce qib muaj nyob nrog viral los sis dej cawv ntawm daim siab thiab ntau yam kab mob siab nrog mob los yog tsis muaj cirrhotic puas.

Qib siab kom zoo yog mob siab rau tus kab mob siab mob qog siab, tshuaj lom los yog tshuaj necrosis, shock lossis hepatic ischemia.

Ib theem siab tshaj (tshaj li ntawm 2000-3000 U / l) tshwm sim thaum muaj acetaminophen ntau dhau lawm thiab thaum siv cov tshuaj hauv cov neeg mob haus cawv, nrog rau kev poob siab thiab / los yog hepatic ischemia.

Nws yuav tsum tau muab sau, txij ALT yog nyob rau hauv cov erythrocytes, nws yog ib qhov tsim nyog los tiv thaiv lawv cov disintegration thaum npaj cov ntshav dej rau kev tsom xam. ALT tuaj yeem txo thaum uas khaws cov ntshav dej rau ob peb hnub.

Lub luag haujlwm ntawm cov khoom siv kho mob, tshuaj ntsuab thiab lwm yam tshuaj

Cov ntaub ntawv tseem ceeb ntawm cov tshuaj anamnesis thiab kev daws teebmeem ntawm kev kuaj sim yog qhov tseem ceeb rau kev tshuaj xyuas cov tshuaj uas ua rau muaj kev sib ntxiv ntawm qhov kev hloov. Zoo li ua rau lub siab puas ntsoog hauv 1-2% ntawm tus neeg mob ntawm daim siab mob hauv daim ntawv ntev. Lawv muaj feem xyuam nrog kev siv cov tshuaj tua kab mob, tshuaj siv tshuaj tua kab mob, cov tshuaj hydroxymethylglutaryl-CoA reductase, cov tshuaj uas tsis yog cov tshuaj tua tsis tau tshuaj thiab tshuaj rau kev kho mob ntawm tuberculosis.

Txoj kev yooj yim tshaj plaws los txiav txim siab txog kev nce nyob rau hauv aminotransferases nrog rau tej yam kev kho yog tshem tawm thiab saib cov qib ntawm cov enzymes. Yog tias tsis muaj kev tso cai ntawm cov nyiaj, qhov kev pab no tsis tuaj yeem txiav txim siab tau.