The liver performs important functions necessary to maintain the he alth of the body. Diseases of the gland are not always manifested by painful sensations in the area where the organ is located. The manifestation of symptoms in the form of pain in the right hypochondrium, stool disorders indicate serious problems with the liver. To detect the pathological process in the early stages allows a preventive examination of the organ. Liver tests are the main diagnostic method. Which ones to take, the doctor determines after examination and history taking.
Liver Functions
In the human body, there are several glands that perform secretory, barrier and other functions. The liver is the largest secretory organ. Due to the close connection of the liver with other organs and blood, iron performs several important functions:
- homeostatic - participates in lymph formation, removes and neutralizes infectiousagents, removes toxins; regulates blood clotting;
- excretory - excretes more than 40 compounds with bile (cholesterol, phospholipids, bilirubin, urea, alcohols and others);
- protective - neutralizes foreign, toxic compounds that come with food and form in the intestines;
- depositing - hepatocytes accumulate high-energy compounds (anhydrides, guanidine phosphates, enolphosphates) and simpler, but no less important substances (carbohydrates, fats);
- metabolic - in the nuclei of the liver parenchyma there is a synthesis of nuclear proteins, transcription of RNA.
Disorders of the liver leads to a sharp deterioration in the functions of the whole organism. The identification and application of timely therapeutic measures will help keep the gland he althy. Therefore, everyone should have at least a general idea of what tests to take to check the liver. Knowing the types of examination, the patient will be able to properly prepare, which will ensure the reliability of the results.
When should I check the liver
Iron "works" constantly. Poor-quality products, poor ecology, stress put an additional burden on the body. Liver checks should be done annually.
When recognizing gland pathologies, anamnesis is important. Typical symptoms of impaired liver function are:
- feeling of pressure, heaviness in the right hypochondrium;
- periodic epigastric pain;
- bitterness in the mouth, especially in the morning and a long break betweenmeals;
- decreased appetite, intolerance to foods with a pungent odor, up to a feeling of nausea;
- violation of the stool, changing its color to light;
- bloating, full feeling;
- dry skin, unpleasant feeling of irritation, peeling;
- general weakness, fatigue;
- women have menstrual irregularities.
The doctor finds out if the patient has alcohol addiction, diseases in which they take drugs that negatively affect the liver. Often, problems with the organ are discovered by chance during medical examinations. The doctor draws attention to the fact that an adult has increased bilirubin - this means that the excretory function of the gland is impaired. The hepatologist prescribes additional tests to help identify the cause of the organ's dysfunction.
What tests to take to check the liver
Study of the gland includes a set of diagnostic methods. They are divided into general and specific, the latter are prescribed to confirm the preliminary diagnosis based on the patient's complaints and the results of tests that determine the general condition.
General tests:
- Clinical blood test. With liver damage, a reduced hemoglobin content is observed, leukocytes exceed 4-910⁹ / l. An elevated ESR indicates the presence of an inflammatory process. Low albumin levels indicate liver problems.
- General study of urine. After deliverybiomaterial for research, patients ask the doctor if a urine test will show problems with the liver. Violations of the he alth of the gland are reflected in all biological fluids. A high content of bilirubin and urobilin in the urine indicates a violation of the excretory function of hepatocytes.
Specific:
- Analysis for biochemistry. The study is complex. The biomaterial for the test is venous blood. Liver studies are carried out using enzymological tests, PCR analysis, Quick-Pytel test, sulene and coagulation tests.
- Liver tests - Liver enzymes tested using biochemical analysis.
- Hepatitis testing. Hepatitis antibody tests are an indicator of past hepatitis and immune response against hepatitis viruses. Samples for hepatitis B and C are among the mandatory examinations. Testing is carried out during medical examinations for work, in educational institutions, upon admission of the patient to the hospital. Hepatitis B and C markers are used to detect the presence of the virus in the body.
- Coagulogram is a test that detects violations of hemostasis. The analysis is carried out with suspected or diagnosed liver pathologies.
- Fibrotest - a study that reveals the presence and degree of fibrotic changes in the organ.
Specific tests are of great diagnostic value, let's take a closer look at them.
What does a blood test for biochemistry show
Methods for studying the components of biological fluids, the processes of converting substances and energy have a hugevalue in diagnosis. They allow you to evaluate the work of internal organs and systems. Inorganic and organic substances, proteins, nucleic acids are subjected to research.
In some laboratories there are sets of tests for biochemistry to check the liver. They include all the indicators by which the doctor evaluates the work of the body. In outpatient conditions, the doctor prescribes each blood component separately:
- Prothrombin is a coagulation test used to diagnose pathologies associated with a deficiency of coagulation factors, thrombosis. With cirrhosis of the liver, prothrombin levels are significantly reduced.
- Alpha-Amylase is a calcium-dependent enzyme synthesized by the salivary and pancreas glands. The norm of indicators is 25-125 Units / l.
- Cholinesterase is an enzyme belonging to the group of hydrolases, necessary for the breakdown of choline esters, synthesized in the liver. The main function of the enzyme is the processing of toxic substances. Exceeding the content of 5300-12900 units / l indicate violations of the liver.
- Total protein - the total concentration of albumin and globulins in the blood. The indicator is necessary for the diagnosis of liver pathologies, metabolic disorders. The norm of protein content in the blood is 65-85 g / l. A decrease in the level can be caused by liver failure due to toxic lesions of the gland, hepatitis, cirrhosis.
- Bilirubin direct is a water-soluble bile pigment excreted from the body with bile. In a he althy person, the indicators do not exceed 3.4 µmol / l. The main cause of hyperbilirubinemia is damage to hepatocytes. Straightbilirubin increases with parenchymal jaundice, alcoholic and viral hepatitis.
Liver tests
Analysis for biochemical enzymes that help assess the degree of damage to the liver is called liver tests. It is prescribed both to patients with signs of gland pathology, and without characteristic symptoms.
Assess liver enzymes in a biochemical blood test. According to the test results, the ability of the gland to absorb toxic substances, remove them from the blood, and metabolic function are studied.
Liver Values:
- Albumin is a protein fraction synthesized by the liver. Normally, the content of the substance in the blood serum is 55.2-64.2%. Reduced rates indicate diffuse lesions (changes in size and structure) up to dystrophy and necrotization. The enzyme content below 40% is an indicator of chronic liver failure.
- Alanine aminotransferase (AlAT) and aspartate aminotransferase (AsAT) are enzymes that ensure the transfer of alanine to alpha-ketoglutaric acid. Enzymes are synthesized intracellularly, only a small part of them enters the bloodstream. With liver damage, the concentration of ALT and AST in serum exceeds the limits of 0.9–1.75.
- General bilirubin is a bile pigment formed during the breakdown of hemoglobin, hemoproteins, myoglobin. In case of violation of the liver, the absorption of the pigment decreases and the violation of its release to the intrahepatic bile ducts. Increased bilirubin, what does this mean in an adult? A high concentration of yellow pigment cantestify to hepatitis, abscess, cirrhosis of the liver. Low levels may be due to antibiotics, salicylates, corticosteroids.
- GGT (Gamma-glutamyltransferase) is a liver protein whose activity in blood serum increases with alcohol abuse and gland pathologies.
- Alkaline phosphatase (AP) is an enzyme that dephosphorylates alkaloids and nucleotides. Normally, the content of alkaline phosphatase is 30-130 units / l. Exceeding the concentration can be caused by cirrhosis, tuberculosis of the liver.
Not a single indicator is given separately about the presence of pathology, its severity is judged only by the results of a comprehensive examination.
Coagulogram
Tests to check the liver, in addition to biochemistry, include indicators of hemostasis. The gland performs a homeostatic function, blood clotting disorders can be caused by damage to hepatocytes, the formation of scars in the parenchyma of the gland.
Coagulogram (hemostasiogram) - a study of the coagulation and anticoagulation ability of blood. The analysis allows to identify chronic liver diseases. coagulogram includes the study of several indicators. For the diagnosis and monitoring of gland pathologies, the following are of value:
- Prothrombin time and INR are indicators of the external pathway of blood coagulation. INR is the ratio of the patient's PV to the standard PV. Normal PV values are 11-15 sec. An increase in indicators may be associated with cirrhosis, hepatitis.
- Thrombin time is a test that determinesthe rate at which a fibrin clot forms after thrombin is introduced into the blood. Normal values range from 14-21 seconds.
- Fibrinogen is a protein that forms the basis of a clot during blood clotting, produced in the liver. A decrease in the level of reference values (1.9-3.5 g / l) may indicate inflammation of the liver tissue, degeneration of the parenchyma into fibrous tissue.
- Antithrombin III is a protein that prevents excessive formation of blood clots. Glycoprotein is produced in hepatocytes and in a single layer of vessels and is an endogenous coagulant. In adults, the normal level of antithrombin III is 66-124%. One of the reasons for the increase in glycoprotein are acute cholestasis and hepatitis. A low content of the enzyme indicates, among other things, cirrhosis of the liver, liver failure.
- D-dimer is a protein that reflects the activity of thrombus formation and fibrinolysis. The level of D-dimer in a he althy person does not exceed 0.55 μg FEU / ml. One of the factors affecting the increase in the rate is liver disease.
To assess the state of the gland, they look at what a blood test shows for biochemistry and a coagulogram. Only on the basis of the results of a comprehensive examination, the doctor can make a diagnosis.
Markers of viral hepatitis
If a significant excess of bilirubin, alanine aminotransferase, aspartate aminotransferase, albumin is observed in the biochemistry analysis, the doctor prescribes additional studies for hepatitis.
Botkin's disease is detected usingenzyme immunoassay using the anti-HAVIgM marker. Antibodies are produced from the first days of infection.
The following markers are used to detect hepatitis B:
- Anti-HBsAg - antibodies to hepatitis B surface antigen, an indicator of previous illness;
- HBeAg - marker reveals the active stage of the disease;
- Anti-HBc - detects the presence of antibodies, but does not provide information on the degree of progression of the pathology;
- Ig Anti-HBc - indicates the active reproduction of an infectious agent;
- Anti-HBe - found during recovery.
Hepatitis C markers:
- Anti-HCV - total immunoglobulins M and G. Antibodies are detected 4-6 weeks after the infectious agent enters the body;
- Anti-HCV NS are found in acute and chronic pathology.
- HCV-RNA indicates the activity of the virus.
When markers are found, additional tests are ordered to check the liver. Confirm the presence and progression of hepatitis by PCR. High-quality PCR helps to choose the right dosage of medicines.
Testing for autoimmune hepatitis
Chronic inflammatory process in the liver, characterized by peripartum lesions and the presence of autoantibodies to hepatocytes is called autoimmune hepatitis. It is much less common than, for example, viral, but it is also dangerous.
The basis of the pathogenesis of the disease is the deficiency of immunoregulation. Due to a sharp decrease in T-lymphocytes, the number of B-cells sharply increasesIgG, which leads to the destruction of hepatocytes. There are 3 types of autoimmune hepatitis:
- I (anti-ANA) - more commonly diagnosed in people aged 10-20 years and older than 50. Responds well to immunosuppressive therapy. If left untreated, cirrhosis develops within 3 years.
- II (anti-LKM-I) - this form is more often diagnosed in childhood, more resistant to immunosuppression. Relapses often occur after stopping medication.
- III (anti-SLA) - observed in people who have been ill with the first type.
Types of tests to diagnose the liver for autoimmune hepatitis:
- gamma globulin and IgG levels;
- biochemical analysis (AST, ALT, bilirubin and others);
- markers of autoimmune hepatitis: SMA, ANA, LKM-1;
- liver biopsy.
What is a fiber test
Inflammatory processes in the liver cells, alcohol abuse, frequent use of antibiotics, the presence of hepatitis lead to liver fibrosis. Violation of the morphogenesis of the liver tissue (replacement of the parenchyma with connective tissue) and bile ducts leads to liver failure.
Fibrosis test is done to detect fibrosis. This analysis for checking the liver is considered an analogue of a biopsy, for which there are a lot of contraindications. The studied biomaterial for fibrotest is venous blood.
The essence of the study is to detect specific biomarkers in the patient's blood plasma, indicating the presence and degree of growth and scarring of the parenchymal tissue. Alsoanalysis reveals fatty degeneration of the gland (steatosis). The doctor who ordered the examination is responsible for interpreting the results.
Deciphering liver fibrotest:
- F0 - no signs of pathology;
- F1 – single septa observed;
- F2 – portal fibrosis;
- F3 – multiple portal-central septa revealed;
- F4 - cirrhosis of the liver.
In addition to alphanumeric, there is a color interpretation that judges the degree of pathology:
- "green" - no disease or latent stage of development;
- "orange" - moderate degree of fibrosis;
- "red" - pronounced damage to the parenchyma.
Liver Function Assessment
To assess the work of the gland, various functional tests are used:
- Bromosulfophthalein test. The method allows you to explore the absorption and excretory function of the body. The test is highly accurate and easy to perform. A 5% solution of bromsulfatelein is injected into a vein at the rate of 5 mg per kilo of weight. After 3 minutes, readings are taken and taken as 100%. After 45 minutes, the residue of the dye is calculated. Normally, it is 5%. The use of this analysis in liver disease that occurs without jaundice allows early detection of pathological changes in hepatocytes.
- Vofaverdin test is aimed at detecting a small gland deficiency (hepatodepressive syndrome). A solution of vofaverdine is injected into the vein, after 3 minutes a measurement is made, repeated after 20 minutes. Normally, the dye should remain no more than 4%. The substance can cause allergies, and also contributes to the formation of blood clots, so the test is used infrequently.
- Galactose test (Bauer). With the help of the study, violations of the breakdown of carbohydrates in the liver are revealed. A solution of galactose (40%) is administered intravenously at the rate of 0.25 g per kg of body weight. Blood is taken 5, 10 minutes and 2 hours after the administration of the reagent. In liver disease, galactose is not converted to dextrose.
- Kvik-Pytel's test. Testing evaluates the antitoxic function of the gland. The patient on an empty stomach drinks a glass of coffee and eats 50 g of crackers. An hour later, he drinks 30 ml of water with sodium benzoate (4 g) dissolved in it. Immediately drinks another glass of plain water and passes control urine. Then every hour the patient gives more urine. Hydrochloric acid is added to all portions and shaken thoroughly. After an hour, the precipitate is filtered and dried. The weight of the dry residue is multiplied by 0.68. A significant decrease in sediment (up to 80%) indicates toxic liver damage.
Conclusion
No one is safe from liver disease. They are dangerous for their long asymptomatic course. The absence of unpleasant manifestations in the form of pain does not mean that the gland is he althy. The condition of an organ can only be assessed based on the results of diagnostics.
Knowing which blood parameters indicate liver disease is not enough, it is important not to expose the organ to "danger". Proper nutrition, avoiding alcohol, taking medications only under the supervision of a doctor, using contraceptives during sex will help protect the gland from pathologies.
