A 25 -year -old woman, at 14 weeks of pregnancy, only the hepatic function was cenrominase 57 IU/L. Grassamotinase was normal. At 17 weeks, gifda aminotransferase and gyanases exceeded 200 IU/L.
During this period, the lady did not have a cold and had a fever, and she had no other body uncomfortable. She usually had some composite vitamins and calcium carbonate vitamin D3 tablets.I did a check before pregnancy, but I didn’t know the specific results, because the doctor didn’t say anything during pregnancy.
Many women are like this after pregnancy: they go to the hospital for examination, doctors do n’t say, they do n’t ask them, they do n’t know what items they check. By default, doctors do n’t say that they may not have much problem.
Today, with the actual situation of this woman, Dr. Long came to popularize women after pregnancy. What are the reasons for rising transaminase.
Women are pregnant for 14 to 17 weeks and are mid -term pregnancy.
During this period, liver function tests prompted aspinase and croaraminase to increase, from 57 to 200, and have eaten composite vitamin and calcium carbonate vitamin D3. Women are worried that these drugs will cause liver damage. This idea can be understood.
However, these two drugs are supplemented with various vitamins and calcium. Vitamins and calcium are nutrients that the human body needs normally. Unless excessive amount, it is unlikely to cause risen aminotransferase and croaran aminase.
So, what is the reason for?
Acelase enzymes and crooquinase are the most important items in liver function tests.If these two transaminases are rising, hepatocytes are often damaged.
Because under normal circumstances, these two transaminases are in cells.The human body has a small amount of hepatocyte aging and death every day. The transaminase in the cells will be released, and then absorbed by the blood, so that under normal circumstances, a certain amount of transaminase can be detected.Their normal reference range is usually less than 30 to 50 IU/L, which vary depending on the standards of each laboratory.
Givenal aminotransferase and crooquinase are elevated to reach more than 200, indicating a medium -level liver damage; the judgment of the degree of liver function damage is a rough judgment.In fact, the degree of liver function damage is more important to look at the gallblade, coagulation function and other indicators.
The medium level of liver damage is also in a special pregnancy period. The common causes are as follows:
Viral hepatitis is what we usually call infectious hepatitis or "hepatitis". There are five types of hepatitis A, B, C, Ding, and penta.The most common reasons for rising transaminase.
Viral hepatitis has acute and chronic.
Chronic hepatitis usually does not have obvious symptoms, or only has some very reliable symptoms; and acute hepatitis usually experiences manifestations such as systemic fatigue, loss of appetite, nausea, tiredness, bloating, yellowing, vomiting and abdominal pain, and even fever.
Viral hepatitis should be clearly diagnosed. Items that need to be detected include: hepatitis A antibody, two -pair of hepatitis B, hepatitis C antibody, diced hepatitis antibody, and pental antibody.In the case, it is necessary to detect the hepatitis B virus DNA and hepatitis C virus RNA, or color Doppler ultrasound, and so on.
Many drugs must be metabolized by the liver.
Then, in the process of metabolism through the liver, it is possible to aggravate the burden on the liver or damage the liver cells, which will lead to an increase in galcoplase aminotransferase and gylinase.These drugs include Chinese herbal medicine, antibiotics, antitumor drugs, antipyretic analgesic drugs, immunosuppressive drugs and anti -psychiatric drugs, and so on.
There is no specific diagnostic method of drug -induced liver injury. It mainly depends on the history of medication or long -term medication for a long time by reviewing the diagnostic basis, and eliminating other reasons to comprehensively judge.
It is particularly reminded that pregnant women are that some antipyretic and safe proprietary Chinese patent medicines often contain acetaminol (this medicine is not taboo in pregnant women), which is one of the important drugs that cause liver injury.
Fatty liver is divided into alcoholic fatty liver and non -alcoholic fatty liver.
The pathological characteristics of these two kinds of fatty liver are actually similar. Both have fat infiltration in liver cells, that is, the amount of fat contained in liver cells is too high, so as to disturb the normal function of liver cells, induce the liver cells to induce liver cellsInflammation has led to the increase in the increase of gifda aminotransferase and gylinase.
The diagnosis method is based on the history of drinking or whether it is a fatty liver caused by obesity, whether there is metabolic disorders such as diabetes, hyperuric acid, and hypertension.During the pregnancy of pregnant women, the burden on the liver is worsen, and the diet may be excessive, which may cause fat to deposit in liver cells, which will cause fatty liver.
Acute fatty liver during pregnancy is a special disease during pregnancy. In this case, liver function can deteriorate rapidly, and at the same time, it may be accompanied by coagulation function changes and jaundice, color Doppler ultrasound and "liver bomb" examination (such as instantaneous elastic imaging examination of the liver) Be able to help diagnosis.
Other liver diseases include autoimmune liver disease, metabolic liver disease (such as hemorrhoid disease, etc.), and hyperthyroidism or loss of thyroid dysfunction.During pregnancy, there is also a proprietary disease, called intrahepatic cholenecaste accumulation during pregnancy. In addition to abnormal transaminase, this disease is also accompanied by elevated bile acid, skin itching, and changes in coagulation function.
Another 29 -year -old lady was the second child, a single pregnancy, 14 weeks.
Entering the hospital due to nausea, vomiting, and loss of appetite.During the premature pregnancy of the previous pregnancy, she also had nausea and vomiting, and gradually faded after entering the mid -term pregnancy.
There were no big health problems in the past.I usually eat some vitamins and folic acid, and do not take any other drugs, including supplements.The physical examination is not special, the lips are dry, and the eyes are not yellow (sclera), and the liver and spleen are not touched.
Checking liver function after admission: gifda aminotransferase (Alt) 175 IU/L) and gyanase transaminase (AST) 122 IU/L. The total bilirubin is slightly higher, more than 30, leukoprotein is slightly lower than the normal value; liver B ultrasonic examinationNormal; serum science tests of type A, B, and hepatitis C are negative; anti -nuclear antibodies are negative; thyroid hormones are normal.
After the patient was treated with symptomatic and intravenous fluid, the clinical situation was improved.
Vomiting stops, but the symptoms of nausea continue to exist, but it can only be tolerated. When the transaminase drops below 100, the bilirubin returns to normal. It is recommended to discharge to continue observation, rest, adjust the diet plan, and not take liver prevention.
At 20 weeks of pregnancy, the patient’s symptoms disappeared, and the results of liver biochemical examination returned to normal.
The symptoms of early pregnancy occur in the patient, which is in line with the manifestation of "pregnancy drama vomiting" (pregnancy reaction).Excluding viral or autoimmune hepatitis can help determine the cause of these conditions is not "liver disease".
Patients in this situation are usually higher than 200U/L, and the degree of elevation of ALT is greater than AST; B -ultrasound is used to observe whether hepatoba and severe fatty liver, and whether the bile duct is expanded; the patient’s medication can help help help helpExclude drug -based liver damage.
In the middle of pregnancy, a sudden elevation of transaminase occurs: on the one hand, it is necessary to doubt whether it is caused by hepatitis B, etc., and on the other hand, it does not rule out the possibility of other viral hepatitis.
In addition, the more important disease is the acute fatty liver and intrahepatic cholecotus stasis during pregnancy. It is recommended to go to the hospital for further examination to determine the diagnosis in order to treat specific causes.Disorders and other reasons.
The most critical way to treat transaminase during pregnancy is to find out the cause and deal with the cause. If the drug that uses liver -keeping enzymes can be unintentionally cover up the condition and causes damage to both fetuses and pregnant women.
Well, this is here today’s popular science, do you understand?If you do n’t understand, you can leave a message to tell me.
I am Dr. Long, who loves popular science. If you want to know more about infection and liver disease, please follow me!
Welcome to comment, like, forward, collect and appreciate it!
“”
“”
