Chapter 5 Liver function tests - medical powerpoints：5章，肝功能试验-医疗幻灯片.pptVIP

Liver Function Test Mild (times) Moderate (times) Marked (times) AST 2-3 2-3 to 20 20 ALT 2-3 2-3 to 20 20 ALP 1.5-2 1.5-2 to 5 5 GGT 2-3 2-3 to 10 10 Hepatic neoplasm markers: Alpha fetoprotein (AFP): 25ug/ L , 500 ug /L: primary hepatocellular carcinoma. Carcinoembryonic antigen (CEA): 0-5 ug /L , increased CEA: liver metastatic carcinoma or other carcinomas of the gastrointestinal system. ??????????????????????????????????????????????????????????????????????????????????? The Child-Turcotte-Pugh Classification Tests of viral hepatitis Viral Hepatitis Hepatitis A (HAV): Food, water borne; heat labile. Fecal - oral contamination; contagious. Usually self limited, lasting days to weeks. 99% spontaneous recovery, no treatment. Tests: HAV IgM antibody = acute infection. HAV total antibody (IgM IgG) = exposure only, could be post infection or vaccination. Viral Hepatitis Hepatitis B (HBV): Blood, semen, saliva, vaginal secretions. Highly contagious; sexually transmitted. 90-95% self limited over 6 months. Chronic infection: 6 months. DNA virus: incorporates into host with chronic infection. Viral Hepatitis HBV Lab Tests: HBV s Ag: surface antigen positive in acute or chronic infection. HBV s Ab: antibody to surface antigen positive in late convalescence, confers immunity, after injection of Hepitis B vaccine. HBV c Ab: core antibody IgM, IgG; only + with infection, not vaccination. HBV e Ag: e antigen, a component of the HBV core envelope antigen; if + actively replicating virus and infectivity. HBV DNA: actual viral load in blood. Viral Hepatitis Hepatitis C (HCV): Blood borne, not in food or water; not highly sexually transmitted*. 20% self clearing; 80% chronicity. RNA virus: does not incorporate into host. Can cause HCC; #1 cause of transplant. Viral Hepatitis HCV Lab Tests: HCV Ab: + means past exposure; can take 3-6 months to form; not found if acute. RIBA / ELISA: used to confirm Ab. HCV PCR RNA: confirms actual viral presen