What Is an Alanine Aminotransferase?

An enzyme involved in the metabolism of human protein (equivalent to a catalyst in industrial production), which accelerates the transformation of protein amino acids in the body. It is widely present in various tissues, organs, muscles and bones of the human body. The most in the serum, the reference value of the normal content of ALT in the serum is: male 9 --- 51U / L, female 8 --- 41U / L (the test methods in different hospitals are different, the reference values are not exactly the same). When various tissues and organs in the human body are active or diseased, the ALT in them will be released into the blood, which will increase the serum ALT content. For example, when the liver is inflamed, the transaminase is released from the liver cells into the blood, the liver is diseased, and the serum transaminase must be increased. When the liver cells are inflamed, the serum transaminase content will more than double. Therefore, the serum The amount of aminotransferase is an important indicator of the degree of liver disease.

Alanine aminotransferase

A protein involved in the human body

Glutamate aminotransferase mainly exists in the hepatocyte cytoplasm, and the intracellular concentration is 1000-3000 times higher than that in serum. As long as 1% of liver cells are destroyed, it can double serum enzymes. Therefore, alanine aminotransferase is recommended by the World Health Organization as the most sensitive test for liver damage.

If the alanine aminotransferase (ALT) serum value exceeds the upper limit of 2-3 times and lasts for more than two weeks, it indicates that there is

Because all tissues and organs of the human body contain

(1) High alanine aminotransferase will cause

At present, there are many types of liver-protecting and enzyme-reducing drugs, but there are few really effective liver-protecting and enzyme-reducing drugs. They must not be abused during the treatment process. The cause of the increase in alanine aminotransferase must be really found For this reason, better results can be obtained. Patients should follow the following three principles during treatment and medication:

First, choose the right and effective liver-protecting and enzyme-lowering drugs. For the treatment of various causes of alanine aminotransferase elevation, the effective drugs are mainly Chinese medicine and its active ingredient extracts. Generally, drugs containing schisandrin, glycyrrhizic acid, oleanolic acid, silymarin and other chemical ingredients are selected. Liuwei Wuling Tablets is composed of schisandra, licorice, forsythia and other drugs. It has the effects of nourishing liver, nourishing kidney, detoxifying and dampening, and can be used to treat various chronic hepatitis patients with increased alanine aminotransferase, which is a new generation of liver protection. Enzyme-lowering drugs have been widely used in clinical practice. As long as patients use the above enzyme-lowering drugs correctly, alanine aminotransferase can be effectively controlled, and the effect of enzyme-lowering treatment is stable and stable.

Second, the course of treatment must be guaranteed. When the enzyme-lowering drug restores alanine aminotransferase to normal, the dosage of the enzyme-lowering drug should be gradually reduced, and the drug should not be stopped suddenly. The course of treatment with enzyme-lowering drugs should be more than 1 year, and even the liver function should be maintained at the lowest level of consolidation treatment. For example, using intravenous drip of Ganlixin to lower the enzyme, after normal liver function, you can change the daily infusion to another infusion every other day, and then once every two days; if you use oral enzyme lowering drugs instead, it is best to choose a strong drug such as Liuwei Wuling tablets, etc., were successfully switched from oral infusion to infusion.

Third, while protecting the liver and lowering enzymes, we must take measures to address the cause of the disease. For example, antiviral and immunomodulatory therapies must be used to treat hepatitis B. The treatment of hepatitis B is a world problem. At present, the best way is to use combined medicine and comprehensive treatment, which is the so-called "single cure". Antiviral therapy is the cure for the root cause, and it is the foundation of treatment. Although there are no specific drugs available for hepatitis B treatment at present, there are some effective drugs. The drugs representing the latest research results are new nucleoside antivirals-adefovir, entecavir, telbivudine, and so on. One of the main drugs for treating hepatitis B now. Hepatitis B patients need to cooperate with antiviral therapy while hepatic protection and enzyme reduction treatment. After long-term effective treatment, the patient's laboratory tests, the hepatitis B virus replication indicators have all turned negative, and seroconversion between the hepatitis B virus e antigen and e antibody has occurred, which means that the condition has fundamentally improved.

If the alanine aminotransferase is temporarily higher, the third line of hepatitis B is normal. You don't need to be nervous or need treatment. Just pay attention to balanced diet, do not overeating, drink less, stay up late, eat less high fat foods, adjustment for a while will be fine. If you are worried about taking some medicines for liver protection, keep in mind that you do nt have hepatitis B right now, so the medicine should be distinguished from medicines for treating hepatitis B, but in general, western medicine is not recommended. reduce

Life aspects of alanine aminotransferase

A high alanine aminotransferase is a more common phenomenon that indicates liver damage. When the alanine aminotransferase is elevated, pay attention to the recovery of the liver and enhance autoimmunity. Generally, there are several precautions:

1. Pay attention to rest, don't stay up late. Normal rest is helpful for the repair of liver function. Learn to take time to rest and eliminate fatigue.

2. Regulate emotions and feel happy. "Do not be angry" in the face of all kinds of pressure will also help improve disease resistance.

3. Exercise properly to avoid fatigue. Practicing yoga, meditation, tai chi, swimming, etc. are conducive to improving the body's immunity.

4. To consciously quit drinking, quit smoking whenever possible. Hepatitis B virus replication and overlapping alcoholic liver disease are chronic hepatitis B to cirrhosis, the triggering condition of liver cancer, and also the reason for the worsening and difficult treatment of liver disease patients.

5. Reasonable and scientific diet: The diet should be light, green vegetables and fruits are rich in antioxidants, which is conducive to liver cell recovery, and should be eaten more: eat less spicy and stimulating foods, grill, fry, pickled, greasy, thick, processed Meat can increase the burden on the liver and should be eaten less.

Alanine aminotransferase drug treatment

In order to alleviate the psychological stress of patients, sometimes drugs that reduce alanine aminotransferase, such as Schisandra chinensis preparations (bifendate, pentaester capsules, etc.) have to be used. When using enzyme-lowering drugs, we must pay attention to the course of treatment. Generally, it takes more than six months. After the alanine aminotransferase is normal, do not stop the drug immediately. Instead, slowly reduce the dose and maintain the medication for a period of time. Once the drug is suddenly stopped, it may occur. The "rebound" of transferase, the level of transferase after "rebound" may exceed that before treatment. When using enzyme-lowering drugs, antiviral and immune modulators should be added as appropriate according to the patient's condition, and the symptoms should be treated the same.

When observing liver function, you should not only observe the transferase, but also consider the liver function series in order to decide the combined medication and comprehensive treatment. For patients with hepatitis B, when the transferase level rises 2 to 5 times, it is the right time for antiviral treatment. If the enzyme-lowering drugs are used blindly, it will interfere with the judgment of the disease and delay the treatment timing.

Alanine aminotransferase diet

Daily diet

Patients with high alanine aminotransferase should pay attention to comprehensive nutrition in daily diet, reasonable mix and prevent partial eclipse. Get enough vitamins, fats, carbohydrates, and protein daily. Three meals a day should be properly matched, vegetarian foods, as much as possible to eat spicy and other irritating foods, to avoid developing a bad habit of partial eating. Drink a glass of milk every day, eat an egg, two or three or two lean meats, a piece of tofu, exchange two vegetables every day, and eat two fruits. In addition, try to avoid spicy food, seafood, fried food, animal offal and other non-digestible food. At the same time, we must quit drinking and smoking.

fruit

Patients with high alanine aminotransferase should eat some acidic vegetables and fruits, such as hawthorn, apricot meat, jujube, tomatoes and so on. In addition, mushrooms, fungus and other edible fungi contain rich polysaccharides, which is very beneficial for strengthening the immune function of patients with liver disease. Green food is the best choice for protecting the liver and nourishing the liver. For fresh vegetables, patients can either eat raw or cook soup and exchange it daily.

Personalized diet

Regarding what to eat with high alanine aminotransferase, patients with high alanine aminotransferase should also follow their own priorities and follow the principle of personalized diet. For example, patients with liver cirrhosis are high in alanine aminotransferase, so the diet is mainly soft, cold and easily digestible food. Patients with high alanine aminotransferase need to be reminded that patients with high aminotransferase can not only focus on what to eat, diet therapy is only an adjuvant treatment, it only promotes the reduction of aminotransferase, can not put the cart before the horse, and ignores the treatment for the cause. Otherwise, the risk of liver fibrosis still exists, and liver disease will develop into cirrhosis and liver cancer. For example, for hepatitis B patients with high alanine aminotransferases, in addition to enzyme-lowering treatment, comprehensive treatments such as antiviral, antifibrotic, and liver function restoration are also required.

Alanine aminotransferase for pregnant women

Since the content of transaminase in the whole liver is about 100 times that in blood, if all the released enzymes remain active, as long as 1% of hepatocytes are necrotic, it is enough to double the enzyme activity in serum. Because the concentration of transaminase in liver cells is 1000-5000 times higher than that in serum, transaminase in liver cells can also leak into the blood due to such a difference in concentration. Therefore, serum transaminase activity is a sensitive indicator of liver cell damage. Normal value: alanine aminotransferase Reitman method: male <40 / L, female <35 / L

Viral hepatitis This is the most common cause of increased glutamate alanine aminotransferase, or CPT. In all types of patients with acute and chronic viral hepatitis, CPT can be increased, but the increase is not proportional to the degree of liver damage, and the CTP value must not be used to judge the severity of the disease.

A variety of drugs and chemical preparations of toxic hepatitis, such as erythromycin, isoniazid, buta pine, etc. can cause CPT to rise, CPT soon returned to normal after stopping the drug.

Cirrhosis and liver cancer CPT in patients with cirrhosis, primary or metastatic liver cancer is often higher than normal. However, the GPT index of some patients does not change significantly. At this time, other enzymes and alpha-fetoprotein in the blood can be added. At the same time, B-ultrasound or CT examination can also help differential diagnosis.

Many studies of alcoholic liver disease have shown that CPT levels are increased in patients with alcoholic hepatitis, cirrhosis and fatty liver, but patients with fatty liver are also accompanied by increased cholesterol and triglyceride levels.

During acute episodes of biliary diseases such as cholecystitis and cholelithiasis, the CPT index of the patient may also increase, but they are accompanied by symptoms such as fever, abdominal pain, jaundice, and elevated bilirubin. After the inflammation is controlled, the CPT can be reduced to normal.

Heart disease CPT levels increase during acute myocardial infarction, myocarditis, and heart failure, but the increase is not as significant as that of COT (aspartate aminotransferase).

Some other infectious diseases such as pneumonia and tuberculosis may also increase CPT, but these diseases have their own special clinical manifestations, which can be clearly diagnosed with the help of some laboratory tests.

In general, the content of transaminase in serum may fluctuate slightly with physiological changes. After pregnancy, due to changes in endocrine function and increased systemic blood flow, the functional burden on the liver also increases. Especially after the second trimester, as the fetus grows up, the functional changes of the liver become more pronounced; coupled with the increased uterine compression of the liver, the liver circulation is also affected to some extent, so the transaminase value at this time can be slightly increased . This is a physiological change, which is fundamentally different from the organic lesions of the liver. It can return to normal after delivery, so there is no need to worry about it. For patients with high HBV viral load, it is recommended to use drugs with strong antiviral effects, such as Runzhong (Entecavir Dispersible Tablets). This is because Runzhong (Entecavir Dispersible Tablets) has a strong antiviral effect, a low drug resistance rate, and a significantly lower price compared to similar drugs. If the virus is not very high, or has already developed resistance to lamivudine and telbivudine, you can consider taking adefovir-type antiviral drugs as the representative for antiviral treatment. Adefovir has mild inhibitory effect on the virus, low resistance, and no cross-resistance with lamivudine and telbivudine.

However, it should be noted that if transaminase continues to increase during pregnancy and there is a large gap from normal values, accompanied by fatigue, loss of appetite for a long time, and jaundice, etc., you should be vigilant against viral hepatitis, especially hepatitis B. It may be necessary to ask a doctor for further examination. If the hepatitis B surface antigen and E antigen are positive, it is a sign of hepatitis B. The risk of transmission from mother to child is greater. Close monitoring and proper treatment are needed. Newborn babies born to pregnant women with E antigen positive should be injected with hepatitis B vaccine and high titer immunoglobulins within 24 hours of birth. ^[2]