Ngā Whakamātautau Mahi Ate Rerekē (LFT): Te Tikanga o ngā Hua, Ngā Take me ngā Mahi e Whai Ake Nei

Take take

• He tohu noa iho te LFT rerekē, ehara i te mate. Ka puta ake pea ēnei tau i te ate momona, i te huaketo, i te rongoā, i tētahi take ehara i te ate.
• He mea nui ake te tauira i tētahi tau kotahi. He rerekē ngā ahunga e tohu ana i ngā tauira pūtau ate (ALT/AST te matua) me te tauira pūtau ate cholestatic (ALP/GGT/bilirubin te matua).
• Kāore ngā LFT noa e ārai i te mate ate. Ka puta pea te mate ate me te fibrosis nui me ngā whākōkī noa.
• He mea nui kia tere te puta o ētahi āhuatanga rerekē. Me arotake wawe te mate kiriuhi me te pōhēhē, te hiamoe, te toto rānei.
• Ko te whakamātautau anō te taahiraa tika e whai ake nei, ā, nō te tākuta nāna i tono te whakamātautau te whakamaoritanga. Ka rerekē ngā hua i runga i ngā āhuatanga haumanu takitahi.

I te titiro

E mohiotia ano ko

• LFT, panera ate, kōtaha ate, matū ate, panera mahi ate
• Te whakamātautau SGPT me te SGOT, ngā ingoa Inia o ia rā mō te ALT me te AST
• "Whakamātautau ate", "whakamātautau toto ate", "whakamātautau jaundice" (e aro ana ki te bilirubin)
• Reo ā-Iwi: te ate ki jaanch, whakamātautau peelia
• Kia mōhio: he ingoa hītori te "whakamātautau mahi ate". Ko te nuinga o ngā wāhanga ka ine i te whara o te ate, i te rere rānei o te au, kaua ki te mahi tuturu.

He aha te LFT rerekē?

Ka ripoatahia e te panera ate ētahi inenga kāore e pā ana. He rerekē te whanonga o ia inenga:

• SGPT/ALT me te SGOT/AST he whākōkī e tukuna ana ina whara ngā pūtau ate. I ahu mai hoki te AST i ngā pūtau uaua, ngākau me ngā toto whero, nō reira ka taea e te AST te piki ake me te kore he mate ate.
• KI P ka piki ake me ngā raruraru o te awaawa au, engari ka puta mai anō hoki i te wheua, te whenua me te whekau. Ko ngā tamariki e tipu haere ana me te haputanga ka whakaatu i te ALP teitei ake.
• Ko te toronga GGT he tairongo engari kāore i te motuhake. Ka piki te GGT me te waipiro, ētahi rongoā me te ate momona, ā, kāore e nui te pānga o te pikinga o te GGT anake.
• Bilirubin Ka piki ake te toto i te kore e pai te whakahaere i te au o te ate, te aukati i te awa au, te pakaru rānei o ngā toto whero (hemolysis). Ka puta he pikinga ngawari kore-honohono o te mate Gilbert, he maha ngā wā ka kitea ake i muri i te nohopuku, i te mate rānei.
• Pūmua me te pūmua katoa e whakaata ana i te hanganga, engari e whakaata ana hoki i te kai, te mumura, te ngaronga o te pūmua i roto i te whatukuhu me te ngaronga o te puku.
• PT/INR (he maha ngā wā ka tonoa motuhaketia) tētahi o ngā tohu tūturu torutoru o te mahi hanga ate.

Ko te tikanga o te haki "rerekē" i runga i tētahi pūrongo, kei waho te uara i te wā tohutoro o taua taiwhanga. He rerekē ngā wā tohutoro i waenga i ngā taiwhanga mā te tikanga, te kaitātari me te taupori, koia te take ka taea ai te tohu i te toto kotahi i roto i tētahi taiwhanga, kaua i tētahi atu. Pānuihia tonutia ngā awhe kua tāia ki tāu ake pūrongo, kaua e whakataurite ki tā tētahi atu.

He aha i tirotirohia ai ngā LFT rerekē

• Hei wehewehe i ngā take o te ate mai i ngā take ehara i te ate, pērā i te whara o te uaua, te mate tairoi, te mate celiac, te ngoikore o te ngakau, te hemolysis rānei.
• Hei tautuhi i ngā take ka taea te rongoā: te mate ate hepatitis B me te C, te mate ate autoimmune, te mate Wilson, te haemochromatosis, te whara ate i puta mai i te rongoā, te aukati i te awaawa au.
• Hei kimi i te mate ate steatotic e pā ana ki te ngoikore o te pūnaha io (MASLD), te kupu o nāianei hei whakakapi i te NAFLD, me te rapu mō te fibrosis, koinei te kitenga e tino pā ana ki ngā putanga mō te wā roa.
• Hei aromatawai i te kaha o te mate ina kitea te jaundice, te ascites, te pōhēhē rānei.

Ko wai me whakamātautau i te mahi ate

• Te hunga e pāngia ana e te mate kiriuhi, te mimi mangu, te tūtae koma, te mākati tonu, te mamae o te puku matau o runga, te whakapairuaki kāore e taea te whakamārama, te ngenge nui rānei.
• Ko te hunga e pupuhi ana te puku, e ngawari ana te maru, e ruaki toto rānei, me tere tonu te mahi.
• Ko te hunga e pāngia ana e te mate huka momo 2, te ātete ki te insulin, te dyslipidemia, te toto toto tiketike, te taumaha nui rānei, ā, he mea noa te mate ate steatotic. I roto i ngā tāngata o Āhia ki te Tonga, ka puta te mate ate metabolic i te taupū taumaha tinana iti iho i te maha atu o ngā taupori.
• Ko te hunga e tango ana i ngā rongoā ka pāngia e te ate, ina tohutohu te kaitūtohu kia aroturukitia, hei tauira, te rongoā ārai-kohi, te methotrexate, ētahi rongoā ārai-haurangi, ngā rongoā harore, me ētahi rongoā ārai-retroviral. Ka whakaritea ngā wā aroturuki e te kaitūtohu.
• Ko te hunga e whakamahi ana i te AYUSH, i ngā rongoā otaota, i ngā tāpiringa whakaiti taumaha, i ngā tāpiringa whare takaro rānei, he take e mōhiotia ana, kāore anō kia pūrongohia mō te whara o te ate i puta mai i te rongoā i Inia.
• Te hunga inu waipiro auau, te hunga inu nui rānei.
• Ko te hunga he mate ate hepatitis B, he mate C rānei, he mema rānei o te whānau he mate ate hepatitis B, me te hunga he hītori whānau nō te mate ate, te mate Wilson, te mate haemochromatosis rānei.
• Ngā tāngata e mōhiotia ana he mate ate mau tonu, me aro turuki i ia wā.

Ko te tirotiro LFT auau i roto i te tangata kāore he tohu, kāore hoki he āhuatanga mōrearea ka puta he hua āhua rerekē, ā, ka arahina atu ki ētahi atu whakamātautau engari kāore he painga. Kōrerohia ki te tākuta mēnā ka whakautua e te whakamātautau he pātai tūturu māu.

Ngā mea kāore e taea e te LFT te kite, te ārai rānei

• Kāore te LFT e homai he tautuhi mate. Kāore te pikinga o te SGPT e kī ana mēnā he ngako te take, he huaketo, he rongoā, he tukanga ārai mate rānei.
• Kāore te LFT e ine i te fibrosis, i te cirrhosis rānei. He rite tonu, he tata rite rānei ngā whākōkī o te hunga kua pāngia e te mate ate cirrhosis. Kāore te LFT noa e ārai i te mate ate kua whanake haere.
• Kāore te LFT e whakaahua i te ate, i ngā awa wai rānei. Kāore e kitea ngā kōhatu o te puku, ngā kōhatu o te awa au, ngā whēkau, ngā whewhe me ngā pukupuku i runga i te mata toto.
• Kāore te LFT e tirotiro i te mate pukupuku ate. Hei aroturuki i te hunga e mōrearea ana, mā te whakamahi i te whakaahua, me te AFP, me te kore rānei, e ai ki ngā tohutohu a te tohunga ate.
• Kāore te teitei o te whākōkī e rite ki te kaha. Ka puta pea te ALT tino tiketike i roto i te mate hepatitis viral e kore e taea te whakamutu; ka puta pea te ALT tata ki te noa me te cirrhosis kua kore e ea te mate.
• Kāore te albumin me te bilirubin noa e whakaū i te mahi pai i ngā wā tōmua o te mate, nā te mea ka huri ēnei i te mutunga.
• Kāore te LFT e tautuhi i te huaketo motuhake. Me whai whakamātautau serological motuhake te mate Hepatitis A, B, C me te E.

Ko te hua e kiia ana he "kāore i tautuhia" he "i roto i te awhe" rānei, e whakaahua ana i te mea i inehia i taua wā, kāore e whakakore i te mate. Mena ka mau tonu ngā tohu ahakoa he hua noa, me hoki atu ki tō tākuta.

Ngā whakamātautau e pā ana engari he rerekē

He tautoko ēnei, ehara i te whakarōpūtanga. Ko tēhea te mea tuatahi, kei te āhua o te whakaaturanga: ko te kiriuhi kore mamae me te mākūkū me te tauira cholestatic ka tere ake te whakaahua i ngā awaawa o te bile; ko te SGPT kua piki ake me te mate huka, ā, kāore he tohu, ka tere ake te whakamātautau anō, te arotake rongoā me te waipiro, te whakamātautau hepatitis B me te C me te kaute fibrosis i mua i tetahi atu mea.

Me pehea te whakarite

He mahi whakahaere te whakarite, ā, he rerekē i waenga i ngā taiwhanga. Ko ngā tohutohu tuhituhi a tō wāhanga te mea nui i roto i tēnei mahi.

• Kāore te nohopuku e hiahiatia ana mō te LFT anake. He maha ngā taiwhanga Inia e whakakotahi ana i te LFT ki roto i tētahi kete hauora me ngā ngako, te hukahuka nohopuku rānei, ā, i roto i tēnei āhuatanga ka tonoa pea te nohopuku.
• Mauria mai he rārangi katoa o ngā rongoā, tae atu ki ngā rongoā whakamamae mamae, ngā paturopi, ngā rongoā harore, ngā rongoā ārai-kohi, me ngā rongoā otaota katoa, AYUSH, ayurvedic, homeopathic me ngā tāpiringa whare takaro tinana, tāpiringa whakaiti taumaha rānei.
• Kōrerotia ki te taiwhanga te inu waipiro i ngā wā tata nei, te whakakori tinana kaha, te mahi whare takaro rānei, te mate me te haputanga.
• Kawea ngā pūrongo LFT o mua. He maha ngā wā ka nui ake ngā mōhiohio e pā ana ki te ia o te wā i te uara kotahi.
• Kaua e tīmata, e whakamutu, e whakarerekē rānei i tētahi rongoā kua tohua hei "whakapai ake" i te hua. Kōrero ki te kaiwhakatakoto rongoā.

Mena kei te nohopuku koe, ā, kei te tango koe i ngā rongoā whakaheke huka

Ka pā te kore huka ki te hunga e kai ana i te insulin, i te sulfonylurea rānei, ki te nohopuku roa. Pātai atu ki te kaiwhakatakoto rongoā me pēhea te whakahaere i ngā horopeta i te ata nohopuku, te whakarite i tētahi wā moata, me te kawe i tētahi puna huka.

Te wa hapu

Ka piki noa te ALP i te wā e hapu ana nā te hanga o te whenua, nō reira, ehara te ALP i te mea he raruraru ate. Heoi, me arotake wawe te mākūkū i te wā e hapu ana, mō te cholestasis intrahepatic o te wā e hapu ana. Me whakamōhio wawe atu ki tō tākuta whānau he mākūkū hou, he jaundice, he mamae nui o te puku o runga, he ānini, he raruraru tirohanga rānei.

tamariki

He nui ake te ALP i roto i ngā tamariki me ngā taiohi e tipu haere ana, ā, he rerekē ngā wā tohutoro tamariki i runga i te tau. Me whakamārama e te tākuta tamariki ngā hua o te whakamātautau tamariki ki ngā awhe tau motuhake.

Ngā kaumātua, CKD me te ngoikore o te ngākau

Ka heke te albumin i te pakeketanga, te mumura mau tonu, te ngaronga o te pūmua o te whatukuhu me te kore e kai pai. I roto i te ngoikore o te ngākau, ka taea e te pupū o te ate te whakanui ake i ngā whākōkī me te bilirubin me te kore he mate ate tuatahi. Mena he herenga wai tōu, kaua e whakanui ake i te kai wai i mua i te whakamātautau toto i runga i ngā tohutohu whānui.

He aha te mea ka tupu i te wā o te whakamātautau

Ka horoia te kiri e te tākuta toto, ka tāpirihia he tourniquet, ka tangohia te toto, mai i te uaua i te ringa. E torutoru meneti te roa o te tango toto. Tērā pea ka puta he mamae ngawari, he maru poto, he haematoma iti rānei; he mea onge te hemo engari ka taea, nō reira me kōrero mēnā kua hemo koe i ngā whakamātautau toto i mua. Mā te pēhi i te wāhi mō te meneti, e rua rānei, ka whakaitihia te maru. Ko te nuinga o te tangata ka hoki tonu ki ngā mahi noa. Me pupuri te hunga e tango ana i ngā rongoā whakangawari toto i te pēhanga mō te wā roa, ā, me kōrero te rongoā ki te tākuta toto.

Te mārama ki tō pūrongo

Pānuihia ngā awhe tohutoro o tāu ake pūrongo. Kāore e taea te whakataurite i ngā tau puta noa i ngā taiwhanga. Ko ngā pātai whai hua ko: ko tēhea rōpū uara ka piki ake, e hia te nui, ā, kei te rerekē haere?

Tauira pūtau ate

Kāore i te ōrite te pikinga o te SGPT/ALT me te SGOT/AST ki te ALP. Ko ngā hononga noa ko te mate ate steatotic, te waipiro, ngā rongoā me ngā tāpiringa, te hepatitis viral (tae atu ki te hepatitis E, he mea noa i Inia), te hepatitis autoimmune, te mate celiac, ngā mate tairoi me te mate Wilson i roto i ngā tūroro taitamariki.

Tauira kolestatika

Ka piki ake te ALP me te GGT i te nui haere o ngā transaminases, he maha ngā wā ka piki ake te bilirubin, te mimi pouri, te tūtae mā, me te mākūkū. Ko ngā take ko ngā kōhatu o te awaawa o te ate, ngā strictures, ngā pukupuku e pēhi ana i te awaawa, te cholestasis i puta mai i te rongoā me te biliary cholangitis tuatahi. Ko tēnei tauira ka arahi ki te whakaahua o te rākau biliary.

Te pikinga o te bilirubin motuhake

Mena he paku piki te bilirubin, kāore i te honoa te nuinga, ā, he noa ngā uara katoa i roto i te tangata hauora, ko te mate Gilbert, ko te hemolysis ngawari rānei ngā whakamārama noa. Ka aromatawaihia te hemolysis mā te whakamahi i ngā whakamātautau tāpiri pēnei i te tatau reticulocyte me te LDH.

Te ALP, te GGT rānei kua piki ake

Tērā pea ka ahu mai te pikinga kotahi o te ALP i te wheua, i te whenua rānei. Kāore e tino kitea te pikinga kotahi o te GGT, ā, he maha ngā wā kāore e hiahiatia he mahi i tua atu i te arotake i te waipiro me ngā rongoā, me te whakamātautau anō.

He iti te pūmua

Ko te iti o te albumin ka tohu pea i te mate ate mau tonu, engari ka tohu anō hoki i te mate ohorere, te mate pāwera, te mate puku nephrotic, te mate puku ngaro pūmua, te kore kai pai rānei. Me whakamārama te whakaahuatanga haumanu.

Kaua tetahi tau i konei e whakamahia hei tātaritanga mate. Nā te tākuta nāna i tono te whakamātautau te whakamaoritanga, i runga anō i tō hītori mate, ngā rongoā me te whakamātautau.

Ina he te āhua o ngā hua LFT

Te pikinga hē, te pikinga kore rānei i te ate

• AST: Mā te whakakori tinana kaha, te whakangungu taumaha i roto i te whare takaro, ngā werohanga uaua, te mate uaua, te toto toto tiketike i roto i te tauira, me te whara o te uaua o te ngākau, o te angaanga rānei ka piki ake te AST mēnā he ate hauora.
• Ārapi: te hapūtanga (te whenua whānau), te tipu o te tamarikitanga me te taiohitanga, te whakaora i ngā whati me ngā mate wheua.
• Bilirubin: te nohopuku roa, te mate whakapeka rānei i roto i te mate Gilbert; te toto toto i roto i te ngongo tauira; ētahi rongoā e whakararuraru ana i te whakahaeretanga o te bilirubin.
• GGT: te waipiro hou, ētahi rongoā noa, te momonatanga, he maha ngā wā kāore he mate ate nui e pā ana ki te hauora.
• Te whakaroa o te kawe, te tauira toto rānei ka taea e te whakamātautau whakamātautau te whakanui ake i te AST, te bilirubin me te pāhare pāporo i te mea kāore i te tika; mā te whakamātautau anō i te tauira ka ea te feaa.

He whakamārie teka, he whakaiti teka rānei

• Ngā whākōkī noa i roto i te mate matatau: I roto i te mate ate cirrhosis, ka heke te nui o ngā whākōkī ki te taumata noa i te ngaronga o te kiko ate e mahi ana.
• ALT noa i roto i te MASLD nui me te fibrosis he mea noa, nō reira ehara te LFT noa i te ātea.
• I heke te AST/ALT nā te korenga o te huaora B6 kua whakaahuatia, ā, ka taea te whakaiti i te pikinga o te whākōkī e tumanakohia ana.
• Whakamātautau kotahi-ira: Ka rerekē ngā taumata whākōkī i te mate hepatitis C mau tonu me te mate hepatitis ā-pūnaha, nō reira, mēnā he pānui noa i te rā kotahi, ka kore pea e mahi.
• Ka taea e te bilirubin te noho noa i roto i te aukati tōmua o te awaawa ate me te maha o ngā mate ate mau tonu.

Ngā mōrearea me te haumaru

Te whakamātautau toto

He iti noa ngā tūponotanga o te puncture vene: te mamae, te marō, te toto toto, te māuiui o te mahunga, ā, he onge noa iho te mate pāwera o te rohe, te riri rānei o ngā io. He iti noa iho ēnei, ā, he poto noa iho te wā. Me whakamōhio wawe atu te hunga e tango ana i ngā rongoā ārai toto, te hunga rānei e mate ana i te toto.

Whakaahua o raro

Kāore te irahiko ionizing e whakamahia ana e te ultrasound. Kei roto i te CT te pānga o te irahiko, ā, kāore pea te irahiko i roto i te iodine e pai mō ētahi tāngata he ngoikore ō rātou whatukuhu, he tauhohenga rānei o mua mō te irahiko. Me aromatawai te MRI i te haumaru mō ngā tāpiringa, ngā pacemaker me ngā konganuku whakarewa. He rerekē te mōrearea o ia mea, ā, ka whakatauhia i ia take, i ia take.

Te koiora ate

He tikanga whakaekenga te koiora koiora, ā, he mōrearea kei roto ko te mamae, te toto, ā, he onge noa iho, ko te whara i ngā hanganga tata. E whakamahia ana mō ngā āhuatanga ka rerekē te tātaritanga kiko, ā, ko te whakaaetanga he kōrero mō ēnei mōrearea. Ka rerekē ngā hua i runga i ngā āhuatanga haumanu takitahi.

Ngā take o ngā LFT rerekē

• Mate ate steatotic (SLD): te kupu matua i whakaurua mai i roto i te whakaaetanga Delphi maha-hapori o te tau 2023 (Rinella et al.). Ka whakakapia e te MASLD a NAFLD; Ka whakakapia e te MASH a NASH; Ka whakaahuahia e te MetALD te mate ate steatotic e pā ana ki te ngoikore o te pūnaha metabolic me te nui o te takoha waipiro. He wāhanga motuhake te mate ate e pā ana ki te waipiro.
• mate kakā huaketo: te mate ate ate A me te mate ate E (he maha ngā wā ka pāngia e te mate ate, ka puta mai i te wai me te kai, he mea noa ki Īnia), te mate ate ate B me te mate ate C (ka roa pea, ka noho puku hoki), te mate ate ate D mō te hunga whai mate ate ate B.
• Te mate ate e pa ana ki te waipiro, mai i te ate momona ki te hepatitis waipiro ki te cirrhosis.
• Te whara o te ate i puta mai i te rongoā me te tāpiringa: te paracetamol mēnā ka nui rawa te horomia, ngā rongoā ārai-kohi, ētahi paturopi, ngā rongoā ārai-haurangi, te methotrexate, me ngā tāpiringa otaota, ayurvedic me te whakapakari tinana.
• Te aukati i te ate: ngā kōhatu pūkahukahu i roto i te awaawa o te ate, ngā strictures, ngā pukupuku repeure, ngā pukupuku biliary rānei.
• Nga tikanga mate autoimmune: te mate ate ārai mate, te cholangitis biliary tuatahi, te cholangitis sclerosing tuatahi.
• Ngā āhuatanga tuku iho: Te mate Wilson, te hemochromatosis tuku iho, te ngoikore o te alpha-1 antitrypsin, te mate Gilbert (pai).
• Ngā take ehara i te ate: te whara uaua, te myositis rānei, te mate celiac, te mate tairoi, te ngoikore o te ngakau me te pupū o te ate, te sepsis, te hemolysis, te mate urutā Epstein-Barr.
• Ngā pukupuku ate me ngā metastases, me te whēwhe ate.

Me pēhea te aromatawai me te rongoā i ngā LFT rerekē

Ko te kaupapa matua o te whakahaere ko te kimi i te pūtake, ehara i te tau. Ko te huarahi noa ko te tirotiro i te hītori o te waipiro, ngā rongoā me ngā tāpiringa; te whakamātautau; te whakahoki i te LFT hei whakaū; te whakamātautau hepatitis B me te C; te aromatawai pākia o te tinana tae atu ki te huka, te HbA1c me ngā ngako; te whakamātautau tairoi me te celiac mēnā e tika ana; te USG o te puku; me te aromatawai fibrosis me te kaute pēnei i te FIB-4, ā, ka whai ko te elastography mēnā e tohuhia ana. Ka tāpirihia ngā paturopi ārai mate, ngā rangahau rino, ngā rangahau parahi me te caeruloplasmin mēnā e tohuhia ana e te tauira. Ka whakamahia te koiora i runga i te whiriwhiri.

Ka whai te maimoatanga i te tātaritanga: te rongoā ārai huaketo mō te hepatitis B, C rānei mau tonu, te pehi i te ārai mate mō te hepatitis autoimmune, te chelation mō te mate Wilson, te venesection mō te haemochromatosis, te tango i te wai toto, te pokanga rānei mō te aukati, te tango i tētahi rongoā, tāpiringa rānei i raro i te aratohu hauora, te whakamutu i te waipiro me te tautoko hanganga i te wā e whai wāhi ana te waipiro, ā, mō te MASLD he huinga o te huringa āhua noho āta haere tonu, te rongoā i te mate huka me ngā lipid, me te rongoā hou e ārahihia ana e te ate i roto i ētahi tūroro i raro i te tiaki motuhake. Ko te cirrhosis matatau me te ngoikore o te ate ka arahi pea ki te aromatawai i te whakawhitinga toto. He rerekē ngā putanga i waenga i ngā tāngata takitahi me ngā take.

Te whakaiti i te whara ate ka taea te karo

• Te werohanga mō te mate ate hepatitis B, me te mate ate hepatitis A mēnā ka tūtohutia.
• Ka whakaitihia te pānga o te mate hepatitis A me te E mā te wai inu haumaru me te akuaku o te kai.
• Me pātai atu ki te tākuta, ki te kaiwhakahaere rongoā rānei i mua i te tīmatanga o tētahi tāpiringa, hua otaota, rongoā mamae rānei ka hokona kore-tohu, inā koa mēnā he mate ate tōu.
• Kia mau ki te horopeta paracetamol kua tohua e tō tākuta, ā, kia mōhio kei roto hoki i ngā rongoā makariri ngā paracetamol.
• Mā te whakakori tinana auau, te rongoā i te mate huka me ngā ngako momona, me te whakaiti i te inu waipiro ka whakaiti i te mōrearea haere o te mate ate steatotic.
• Me whai i ngā whakamātautau toto aroturuki i tohutohuhia i te wā e rongoā ana mō te mate kohi, mō ētahi atu rongoā paitini ate rānei.

Ngā LFT rerekē i roto i te horopaki Inia

• kupu kupu: Ko te tikanga, e tapaina ana ngā transaminases e ngā pūrongo Inia ko SGPT me SGOT, kaua ko te ALT me te AST. He rite tonu ngā ingoa o ngā whākōkī e rua. Ko te tikanga, ka tuhia te whakaahua ko "USG abdomen" ko "sonography" rānei.
• Hepatitis E me te A he tino take noa iho ēnei o te jaundice whakapeka i Inia, ā, ka memeha haere i te nuinga o te wā, ahakoa he kino rawa te hepatitis E i te wā e hapu ana, ā, me tere te tiaki whānau me te tiaki hauora.
• Te rongoā ārai-kohi e whakamahia whānuitia ana, ā, e mōhiotia ana te whara o te ate i puta mai i te rongoā i te wā e rongoatia ana. Kaua e mutu te ATT takitahi, whakapā atu ki te tākuta e rongoatia ana mēnā ka puta he kiriuhi waikura, he ruaki, he mimi pouri rānei.
• Ngā tāpiringa otaota, ayurvedic me te whare takaro tinana he take noa, ā, kāore i te pūrongohia, mō te whara o te ate. Kawea mai te kete tuturu ki tō wā whakarite.
• Te mate ate pākia i te BMI iti iho: Ka pāngia ngā tāngata o Āhia ki te Tonga e te ātete insulin me te ngako ate ina iti iho te taupū papatipu tinana me ngā paepae hope, nō reira, ko te tangata kāore e āhua taumaha rawa, ka nui tonu te MASLD kei a ia.
• Te āhua o te thalassemia me te anemia ngoikore-rino he mea noa; ka pā pea te toto toto tiketike me te utaina o te rino e pā ana ki ngā whakamātautau ate me ngā rangahau rino.
• Ngā mōkihi tirotiro hauora ka puta he maha ngā LFT āhua rerekē. Kotahi te āhua rerekē o te tangata hauora e tika ana kia arotakehia, kia tuaruatia hoki, kaua e whakaoho.
• Tiaki Raraunga: Ki te tuku koe i ngā taipitopito mā roto i tētahi puka ipurangi, mā roto rānei i tētahi tomokanga tango-pūrongo, ka whakahaeretia te whakahaere raraunga hauora whaiaro e te Ture Tiaki Raraunga Whaiaro Mamati, 2023.

Te utu me te inihua i Inia

Ko te panera LFT paerewa tētahi o ngā whakamātautau toto iti ake te utu i Inia, he rau rau rūpī te nuinga i te rāngai tūmataiti, ā, he maha ngā utu iti, kāore rānei e utua e ngā whare kāwanatanga me ngā whare tūmatanui. Ka piki ake ngā utu ina tae atu te mahi ki te tātaritanga mate hepatitis, ngā panera ārai mate, ngā rangahau rino me te parahi, te ultrasound, te elastography, te CT, te MRI/MRCP, te koiora rānei.

Ngā āhuatanga e pā ana ki te utu:

• Te tāone me te taumata o te whare; Ngā taiwhanga whaimana NABL me ngā taiwhanga kāore i whaimana
• Ahakoa he takitahi te LFT, he wāhanga rānei o tētahi kete tirotiro hauora
• Te maha o ngā tātaritanga kei roto, ko ētahi panera "whakaroa" ka tāpiri i te GGT, te LDH, te PT/INR rānei
• Ngā utu kohi kāinga me ngā mahi tere, ngā mahi rānei i muri i ngā hāora mahi
• Te auau o te whakamātautau me te aroturuki anō
• Ahakoa ka tāpirihia te whakaahua, te kōrerorero rānei ki te tohunga

Te whanonga inihua: he maha ngā wā ka kore e whakaurua ngā tātaritanga hauora ā-waho me ngā tirotiro hauora ārai i roto i te inihua hauora paerewa i Inia, engari ko ngā whakamātautau i mahia i te wā whakaurunga, i te wā tiaki tamariki rānei kua whakaaetia ka hipokina. Ko te kapinga ka whakawhirinaki ki te kaupapa here takitahi, ngā wā tatari me ngā wāhanga mate o mua, whakaū ki tō kaiinihua i mua i te whakamātautau. Ko ngā tatauranga katoa i konei he tohu noa iho, ā, ka rerekē i runga i te wāhi, te whare me te wā; pātai atu ki te whare mō tētahi whakatau tata o nāianei.

Ngā pūrākau me ngā meka

Pātai auau

Kia pēhea te roa o te tukanga LFT katoa?

He torutoru meneti te roa o te tango toto, ā, he maha ngā wā ka tae atu ki te rēhitatanga me te tatari, arā, 15-30 meneti te roa. He rerekē te wā tukatuka taiwhanga me te tuku pūrongo i waenga i ngā whare, ā, e whakawhirinaki ana ki te whakahaere auau, ki te whakahaere tere rānei i te tauira, nō reira pātai atu ki tō pokapū kohikohi mō tāna ake wātaka.

Me nohopuku ahau mō te whakamātautau mahi ate?

Kāore e hiahiatia ana te nohopuku mō te LFT anake. He maha ngā kete hauora Inia e whakakotahi ana i te LFT me te hukahuka, ngā ngako rānei i te nohopuku, ā, i tēnei wā ka tonoa pea kia nohopuku. Whāia ngā tohutohu tuhituhi a tō taiwhanga. Mena kei te tango koe i te insulin, i te sulfonylurea rānei, pātai atu ki tō kaiwhakatakoto rongoā me pēhea te whakahaere i ngā horopeta i te ata nohopuku.

He rite te SGPT ki te ALT, ā, he rite te SGOT ki te AST?

Āe. He rite tonu te SGPT me te ALT i raro i ngā ingoa e rua, pērā i te SGOT me te AST. Ko ngā taiwhanga Inia te tikanga e tāia ana ngā tapanga SGPT me te SGOT. He motuhake ake te ALT ki te ate; i ahu mai hoki te AST i ngā pūtau uaua, te ngākau me ngā toto whero, nō reira ka taea e te AST te piki ake me te kore he raruraru ki te ate.

He paku teitei taku SGPT engari kei te tino ora ahau. He aha te mahi i muri mai?

He mea noa ngā pikinga ngawari takitahi. Ko ngā mahi e whai ake nei ko te arotake i ngā rongoā me ngā tāpiringa, he hītori waipiro, he whakamātautau anō i muri i ētahi wiki me te karo i te whakakori tinana taumaha i mua, te whakamātautau hepatitis B me te C, te aromatawai pākia o te tinana, me te kaute fibrosis. Ka whakatauhia e tō tākuta te raupapa i runga i ō āhuatanga mōrearea.

Ka taea e ngā tāpiringa whakakori tinana, whakakori tinana rānei te whakanui ake i ngā whākōkī ate?

Āe. Ka taea e te whakangungu ātete kaha te whakanui ake i te AST me te ALT mai i te uaua, kaua ki te ate. I tua atu, he maha ngā tāpiringa whakapakari tinana me te whakaiti taumaha kua puta he whara tūturu ki te ate. Kōrerohia ki tō tākuta ngā hua katoa i whakamahia, ko te mea pai ko te kawe mai i te putea, me te whakahua i ngā whakangungu taumaha tata nei i mua i te whakamātautau.

He tohu tonu rānei te pikinga o te bilirubin he mate kiriuhi, he mate ate rānei?

Kāo. Ko te pikinga paku o te bilirubin kore-honohono me ngā uara noa i roto i te tangata hauora he tohu i te mate Gilbert, he rerekētanga tuku iho kāore he kino ka kitea i te nohopuku, i te mate rānei. Ko te hemolysis ngawari tētahi atu whakamārama. Ko te kōwhai e kitea ana me nui ake te taumata bilirubin, ā, me tere te tirotiro hauora.

Ka taea e ngā LFT rerekē te hoki ki te āhua noa?

Ae, he maha ngā wā ka arohia he take e taea ai te whakaora pērā i te rongoā, te tāpiringa, te waipiro, te mate hepatitis viral whakapeka rānei, ā, he maha ngā wā ka whakapai ake te pākia o te tinana i roto i te MASLD. Kāore e taea te whakakore i te cirrhosis kua whakapumautia, ahakoa he maha ngā wā ka taea te whakaroa i te whanaketanga. He rerekē ngā hua i runga i ngā āhuatanga haumanu takitahi.

He pai ake te ultrasound i te LFT?

Kāore tetahi o ēnei i te pai ake; he rerekē ngā pātai e whakautua ana e rātou. E whakaatu ana te LFT mēnā he whara matū koiora, he aukati rānei, me te āhua o te āhua. E whakaatu ana te ultrasound i te hanganga, te ngako, te rahi, te ponapona, ngā kōhatu pūkahukahu, me te whānui o ngā awaawa. Kāore e taea e te ultrasound te aromatawai i te mumura, ā, ka ngaro pea te steatosis ngawari me ngā kōhatu iti o te awaawa pūkahukahu.

Me whakamātauria tōku whānau mēnā he mate hepatitis B tōku?

Ko te tikanga, me whakamātauria ngā whānau me ngā hoa moepuku o te tangata he mate hepatitis B, ā, ki te kore e āraihia, me werohanga. Me whai wā motuhake ngā pēpi hou o ngā whaea he mate hepatitis B. Kōrerohia ki te tākuta e rongoā ana ngā mahere whakamātautau me te werohanga.

Rauemi

• Rinella ME, et al. Te tauākī whakaae a te tini-hapori Delphi mō te whakaingoatanga hou mō te mate ate momona (2023), e tautuhi ana i te mate ate steatotic, MASLD, MASH me MetALD.
• He aratohu haumanu a te American College of Gastroenterology mō te aromatawai i ngā matū ate rerekē. [Whakaūhia te putanga o nāianei, ME MANATOKO]
• Ngā aratohu mahi haumanu EASL mō ngā mate ate cholestatic me ngā whakamātautau kore-whakaekenga mō te kaha o te mate ate. [Whakaūhia te putanga o nāianei, ME MANATOKO]
• He aratohu nā te Whakahaere Hauora o te Ao mō te whakamātautau me te maimoatanga o te mate hepatitis B me te mate hepatitis C. [Whakaūhia te putanga o nāianei, ME MANATOKO]
• Kaupapa Whakahaere Mate Hēpatitis Ā-Motu, Manatū Hauora me te Oranga Whānau, Kāwanatanga o Īnia.
• Te Ture Tiaki Raraunga Whaiaro Mamati, 2023; Te Ture mō ngā Rongoā Tarukino me te Makutu (Pānuitanga Whakahē), 1954.