1, determination of the ratio of serum total protein to albumin

Principle: More than 90% of serum total protein and serum total albumin are synthesized by liver, so the determination of serum total protein and albumin is an important index to reflect liver function.

Clinical significance:

The increase of serum total protein and albumin (1) is mainly due to the decrease of serum moisture, which increases the concentration of total protein per unit volume, but does not increase the total protein of the whole body, such as acute dehydration and adrenal cortex dysfunction.

(2) The decrease of serum total protein and albumin can be seen as follows: (a) Common liver diseases include subacute severe hepatitis, chronic hepatitis, liver cirrhosis and liver cancer. Total amount < 60g/L or albumin.

(3) Serum total protein and bile white increased, when serum total protein >: 80g/L or bile white >; 35g/L, called hyperproteinemia or hypercholesterolemia. Found in (a) various chronic liver diseases. (b)M-proteinemia, such as multiple myeloma and lymphoma. (c) Autoimmune diseases: such as systemic lupus erythematosus and rheumatic fever. Chronic inflammation and chronic infection: such as tuberculosis and malaria.

(4)A/G inversion: seen in severe liver injury and M- albuminemia.

2\ Serum lipids include cholesterol, cholesterol lipids, phospholipids, triglycerides and free fatty acids. Cholesterol and phospholipids in blood mainly come from the liver.

Determination of serum cholesterol and cholesterol lipid.

Clinical significance: A. When liver cells are damaged, such as liver cirrhosis and fulminant liver failure, the total cholesterol in blood decreases. B, cholestasis, elevated blood cholesterol, mainly free cholesterol. The ratio of cholesterol fat to free cholesterol decreased. C, malnutrition and hyperthyroidism when the total cholesterol in the blood decreased.

3\ Serum transaminase (alanine aminotransferase, aspartate aminotransferase)

Clinical significance:

(1) The levels of ALT and AST in acute viral hepatitis increased significantly, reaching 20-30 times of the normal level, but ALT was higher, ALT/AST >；; 1。

(2) Chronic viral hepatitis, slightly elevated or normal, ALT/AST >；; 1。 If alt/ast

(3) Non-viral liver diseases such as alcoholic liver disease, drug-induced hepatitis, fatty liver and liver cancer can be slightly elevated or normal. ALT/AST & lt； 1。 AST of alcoholic liver disease increased significantly;

(4) Liver cirrhosis, intrahepatic and extrahepatic cholestasis, normal or slight increase of transaminase activity, liver cirrhosis

The end stage can be shortened.

(5) AST increased 6-8 hours after acute myocardial infarction.