Why did the 26-year-old man's "transaminase" exceed 40 times during the job physical examination? What is the cause?

Recently, a 26-year-old young man successfully passed the written test and interview of a certain institution and came to the health management center for an entry physical examination. When the chief examiner was dealing with the critical values ​​of the physical examination, he found that the alanine aminotransferase (ALT) value in the young man's liver function was 1680u/L, which was 40 times higher than the normal upper limit. (The normal value of ALT is 0-40 U/L, and the range may be slightly different in different diagnosis and treatment institutions. It is a sensitive indicator of liver damage.) Elevated indicators mainly based on ALT (ALT＞AST) are common in acute or chronic viral hepatitis, non-alcoholic fatty liver disease, and drug (poisoning) liver damage.
The chief physician at the health management center quickly told the young man to go to a specialist for further diagnosis and treatment. The young man felt no obvious discomfort and thought the doctor was making a fuss and did not need treatment at all. The chief physician learned that the young man had a habit of staying up late and drinking alcohol frequently. He was ecstatic about joining a public institution, and he had a party with friends a few nights before the physical examination, drinking and going home in the early hours of the morning every night.

Excessive drinking and staying up late may be the cause of his significantly elevated "transaminase". After the chief examiner's earnest persuasion, the young man finally agreed to go to a specialist for treatment, and the staff of the Health Management Center promptly opened a green channel for him to see a doctor. Later, during the follow-up, the young man told the specialist that he was lucky to be hospitalized in time, otherwise the consequences would be disastrous.

1. Why is the liver important and what are its main functions?

The human liver is the main metabolic organ and is known as the "processing factory" of the human body.

1. Metabolic function. This includes nutrient anabolism, catabolism and energy metabolism;

2. Bile production and excretion;

3. Detoxification function;

4. Functions of hematopoiesis, blood storage and regulation of circulating blood volume;

5. Immune defense function.

2. Does normal “transaminase” mean that the liver is definitely normal?

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are the most widely used biochemical indicators of liver cell damage in clinical practice. ALT is mainly distributed in the cytoplasm of liver cells, and its concentration in the liver is 3000 times higher than that in serum, making it a sensitive indicator of liver cell damage.

However, the level of "transaminase" cannot fully reflect the function of the liver. It is only a component in liver cells. When liver cells are damaged, transaminase may be released into the blood. If the damaged liver cells are not large, the liver can still work normally. For example, some patients with cirrhosis and liver cancer, although their condition is relatively serious, their "transaminase" is within the normal range.

3. Master the seven key points of liver care

The liver is so important, how can we protect it through scientific methods?

1. Keep a regular schedule.

The best way to nourish the liver is to avoid overwork and staying up late, and to ensure adequate rest time every day;

2. Eat a light diet.

It is recommended to eat a diet high in high-quality protein, vitamins, and low in sugar and fat. Remember not to drink excessively and do not eat moldy food. For example, aflatoxin was identified as a Class I carcinogen by the World Health Organization in 1993. It is widely found in moldy food and its products, especially moldy grains and nuts (such as peanuts, corn and their products).

3. Feel happy.

"The liver governs emotions", so maintaining a good mood is a good way to nourish the liver;

4. Do appropriate exercise.

Do some outdoor activities with a slower pace and less physical effort, such as jogging, walking, doing radio gymnastics, and Tai Chi;

5. Do not abuse drugs.

Before taking the medicine, you should consult a relevant specialist and follow the doctor's advice. Especially for patients with chronic hepatitis, if you go to the doctor for other diseases, you must inform the doctor of your condition and choose medicines that cause less damage to the liver to avoid aggravating liver damage due to the medicine.

Common drugs that are prone to liver damage include non-steroidal anti-inflammatory drugs, including commonly used painkillers and antipyretics, as well as anti-tuberculosis drugs, some anti-inflammatory drugs, some drugs for treating mental illness, etc. In addition, some Chinese herbal medicines can also damage the liver if taken improperly.

6. Pay attention to chronic hepatitis.

Patients must receive timely treatment and regular checkups. For example, antiviral drug treatment for chronic hepatitis B, similar to the management of chronic diseases such as hypertension and diabetes, requires long-term regular medication. If the medication is stopped at will, viral rebound, hepatitis activity, worsening of the disease, and even liver failure may occur. While effectively controlling liver disease, pay attention to screening for liver cancer;

7. Prevent liver cancer.

Effective prevention and treatment of liver cancer should attach great importance to early screening, so as to avoid the risk of liver cancer as much as possible. For high-risk groups such as those with hepatitis B, hepatitis C, long-term heavy drinking, cirrhosis, family history of liver cancer, or those who have eaten food contaminated by aflatoxin, it is necessary to check liver function, alpha-fetoprotein and liver imaging examinations (such as liver B-ultrasound, CT or MRI) at least once every six months.

4. Why are health examinations and health management important?

This year, mainland musician Zhao Yingjun and Hong Kong actor Wu Mengda died of liver cancer. This is because the liver has no pain nerves except for the surface capsule, so there are often no obvious symptoms in the early stages of liver cancer. Once symptoms appear, most of them are mid- to late-stage liver cancer. Its malignancy and rapid progression are beyond people's imagination.

While people are sighing and lamenting, they are also more aware of the importance of self-health management. For many diseases, early detection and timely treatment are the key to determining the prognosis. The purpose of a physical examination is to understand the condition of the body, and then intervene in diet or exercise to prevent the occurrence of diseases.

"Fear of going for a physical examination" is the most common thought among many people, especially the middle-aged and elderly people. However, a physical examination can detect physical problems early, diagnose early, treat early, and improve the efficacy. Preventing diseases often costs much less than treating them. People should have a sense of health management and develop a habit of health management. It is recommended to go to a regular health management center for a physical examination regularly.

Through scientific and standardized health examinations and health management, people can benefit in the following aspects:

Effectively control risks - adhere to a healthy lifestyle, exercise scientifically, lose weight scientifically, and reduce the risk of chronic diseases such as hypertension, diabetes, and chronic obstructive pulmonary disease;

Effectively prevent and treat chronic diseases - get sick less often, get sick later, and avoid serious or acute diseases;

Life expectancy is extended - people's healthy life expectancy is extended as much as possible, and living to be a hundred years old is no longer a dream.