No520131204127张肝病常用实验室检查(修改后).pptVIP

肝脏病常见的实验室检查Common laboratory tests of liver disease  The First Affiliated Hospital of Nanjing Medical UniversityDigestive Department YuLianzhen 代谢功能 Metabolism 生物转化作用 Biological transformation 分泌与排泄功能 Secretion and Excretion Functions of the Liver Normal function of the Liver Synthesize function ：It makes 90% of the proteins in the plasma, including albumin ,globulin and clotting factors. Normal function of the Liver Metabolism function：维持血糖稳定，合成肝糖原，还将非糖物质转化为糖原或葡萄糖（糖异生 gluconeogenesis ），并参与脂肪、维生素、激素、胆红素等代谢。 Normal function of the Liver Biological transformation function：氧化(oxidation) 、还原(deoxidation) 、水解(hydrolysis) 、结合反应(binding reaction )。 Secretion and Excretion function：分泌胆汁bile ，排泄代谢产物如胆固醇（cholesterol ）、胆色素（bile pigment）、药物和解毒产物（detoxification product ）。 常用的肝功能试验(liver function test) 蛋白质代谢功能检查(proteins metabolism tests) 脂类代谢功能检查(lipids metabolism tests) 胆红素代谢检查(bilirubin metabolism tests) 胆汁酸代谢检查(bile acid metabolism tests) 摄取、排泄功能检查(uptake and transport tests) 血清酶及同工酶检查(enzymes metabolism tests) 其他检查(others) Chapter One  Protein metabolism function test Apart from r globulin, most of the other plasma proteins such as albumin, glycoprotein , lipoprotein, coagulation factors, anticoagulation factors, fibrinolytic factors and various transport proteins are synthesized by the liver, which is the only organ to product albumin. ?Albumin is related with metabolism ,nutrition ,material transportion and maintenance of the blood colloid osmotic pressure. ?Globulin is closely related to immune function and plasma viscosity. 蛋白质代谢功能检查(proteins metabolism tests) 肝细胞合成大部分血浆蛋白(白蛋白、糖蛋白、多种凝血因子、抗凝因子、纤溶因子、转运蛋白)肝细胞受损→蛋白合成↓，尤其A↓↓→水肿、腹水和胸水 γ球蛋白属免疫球蛋白，单核吞噬细胞系统B淋巴细胞及浆细胞产生，慢性肝炎时 γG↑ 严重肝病→纤维蛋白原、凝血酶原↓↓→皮肤粘膜出血 体内氨基酸及核酸代谢产氨增多→尿素合成↓→肝性脑病 Chapter One  Protein metabolism function test 血清总蛋白和清蛋白、球蛋白测定 Determination of indicators Reference serum total protein （TP）