Mayeso Osazolowereka a Chiwindi (LFT): Kodi Zotsatira zake Zimatanthauza Chiyani, Zomwe Zimayambitsa ndi Njira Zina

Njira zazikulu

• Kudwala kwachilendo kwa LFT ndi chizindikiro, osati matenda. Ziwerengero zomwezo zingachokere ku chiwindi chonenepa, kachilombo, mankhwala kapena chifukwa chosakhala chiwindi.
• Chitsanzocho n'chofunika kwambiri kuposa nambala iliyonse. Mapangidwe a hepatocellular (ALT/AST-dominant) ndi cholestatic (ALP/GGT/bilirubin-dominant) amaloza mbali zosiyanasiyana.
• Ma LFT abwinobwino sachotsa matenda a chiwindi. Matenda a cirrhosis ndi fibrosis yayikulu zimatha kuchitika ndi ma enzyme abwinobwino.
• Zinthu zina zosazolowereka zimafunika kuchitika mwachangu. Jaundice yokhala ndi chisokonezo, kugona kapena kutuluka magazi imafunika kuyesedwa mwadzidzidzi.
• Kuyesa mobwerezabwereza nthawi zambiri kumakhala sitepe yoyenera, ndipo kutanthauzira ndi kwa dokotala amene anapempha mayesowo. Zotsatira zimasiyana malinga ndi momwe wodwalayo alili.

Pang'onopang'ono

Amadziwikanso monga

• LFT, gulu la chiwindi, mbiri ya chiwindi, kapangidwe ka chiwindi, gulu la ntchito ya chiwindi
• Mayeso a SGPT ndi SGOT, mayina a ALT ndi AST omwe amagwiritsidwa ntchito masiku onse ku India
• "Kuyesa chiwindi", "kuyesa magazi a chiwindi", "kuyesa jaundice" (kumayang'ana kwambiri bilirubin)
• Anthu a m'banja: liver ki jaanch, mayeso a peelia
• Dziwani: "kuyesa ntchito ya chiwindi" ndi dzina lakale. Zigawo zambiri zimayesa kuvulala kwa chiwindi kapena kutuluka kwa ndulu m'malo mwa ntchito yeniyeni.

Kodi LFT yachilendo ndi chiyani?

Chiwindi chimafotokoza miyeso ingapo yosagwirizana pamodzi. Chilichonse chimachita mosiyana:

• SGPT/ALT ndi SGOT/AST Ndi ma enzyme omwe amatulutsidwa maselo a chiwindi akavulala. AST imachokeranso ku minofu, mtima ndi maselo ofiira a magazi, kotero AST imatha kukwera popanda matenda a chiwindi.
• ALP Kuwonjezeka kwa mavuto a duct ya bile, komanso kumachokera ku mafupa, placenta ndi matumbo. Ana omwe akukula komanso omwe ali ndi pakati nthawi zambiri amakhala ndi ALP yokwera.
• GGT ndi yovuta koma si yeniyeni. Kuchuluka kwa GGT kumawonjezeka ndi mowa, mankhwala angapo ndi chiwindi chamafuta, ndipo kuchuluka kwa GGT kokha sikumatanthauza zambiri.
• Bilirubin Matendawa amawonjezeka chifukwa cha kulephera kugwira bwino ntchito ya ndulu, kutsekeka kwa ndulu, kapena kusweka kwa maselo ofiira (hemolysis). Matenda a Gilbert amayambitsa kukwera pang'ono kosavulaza, komwe nthawi zambiri kumaonekera kwambiri akatha kusala kudya kapena kudwala.
• Albumin ndi mapuloteni onse zimasonyeza kapangidwe kake, komanso zakudya, kutupa, kutayika kwa mapuloteni a impso ndi kutayika kwa matumbo.
• PT/INR (nthawi zambiri imayitanidwa padera) ndi chimodzi mwa zizindikiro zochepa zenizeni za ntchito yopangidwa ndi chiwindi.

Mbendera "yosazolowereka" pa lipoti imatanthauza kuti mtengo wake uli kunja kwa nthawi yowunikira ya labotale imeneyo. Nthawi zowunikira zimasiyana pakati pa ma labotale malinga ndi njira, chowunikira ndi kuchuluka kwa anthu, ndichifukwa chake magazi omwewo amatha kudziwika mu labu imodzi osati ina. Nthawi zonse werengani magawo osindikizidwa pa lipoti lanu m'malo moyerekeza ndi la wina.

Chifukwa chiyani ma LFT osazolowereka amafufuzidwa

• Kusiyanitsa zinthu zomwe zimayambitsa chiwindi ndi zinthu zomwe sizili za chiwindi monga kuvulala kwa minofu, matenda a chithokomiro, matenda a celiac, kulephera kwa mtima kapena kutuluka magazi m'magazi.
• Kuzindikira zifukwa zomwe zingathe kuchiritsidwa: chiwindi cha mtundu wa B ndi C, chiwindi cha autoimmune, matenda a Wilson, haemochromatosis, kuvulala kwa chiwindi komwe kumachitika chifukwa cha mankhwala, kutsekeka kwa ndulu.
• Kuzindikira matenda a chiwindi a steatotic omwe amagwirizanitsidwa ndi vuto la kagayidwe kachakudya (MASLD), lomwe limagwiritsidwa ntchito m'malo mwa NAFLD, ndikuyang'ana fibrosis, yomwe ndi yomwe imakhudza kwambiri zotsatira za nthawi yayitali.
• Kuweruza kuopsa kwa matenda a jaundice, ascites kapena chisokonezo.

Ndani ayenera kuyezetsa ntchito ya chiwindi

• Aliyense amene ali ndi matenda a chikasu, mkodzo wakuda, ndowe zotumbululuka, kuyabwa kosalekeza, kupweteka m'mimba cham'mwamba chakumanja, nseru yosadziwika bwino kapena kutopa kwambiri.
• Anthu omwe ali ndi kutupa m'mimba, mabala osavuta kapena kusanza magazi, mwachangu.
• Anthu omwe ali ndi matenda a shuga amtundu wachiwiri, kukana insulin, dyslipidemia, kuthamanga kwa magazi kapena kunenepa kwambiri, omwe matenda a chiwindi otchedwa steatotic ndi ofala kwambiri. Ku South Asia, matenda a chiwindi omwe amakhudza kagayidwe kachakudya amapezeka pamlingo wotsika wa thupi kuposa anthu ena ambiri.
• Anthu omwe amamwa mankhwala omwe angakhale oopsa pachiwindi akamalandira malangizo okhudza kuyang'anira, mwachitsanzo mankhwala oletsa chifuwa chachikulu, methotrexate, mankhwala ena oletsa khunyu, mankhwala opha mavairasi, ndi mankhwala ena oletsa mavairasi. Nthawi yowunikira imakhazikitsidwa ndi dokotala.
• Anthu omwe amagwiritsa ntchito AYUSH, mankhwala owonjezera ochokera ku zitsamba, kuchepetsa thupi kapena masewera olimbitsa thupi, zomwe sizimadziwika bwino komanso sizikudziwika bwino chifukwa cha kuvulala kwa chiwindi chifukwa cha mankhwala ku India.
• Anthu omwe amamwa mowa mwauchidakwa nthawi zonse kapena omwe amamwa mowa kwambiri.
• Anthu omwe ali ndi matenda a chiwindi a mtundu wa B kapena C, kapena wachibale wawo amene ali ndi matenda a chiwindi a mtundu wa B, komanso omwe ali ndi mbiri ya banja lawo yodwala matenda a chiwindi, matenda a Wilson kapena haemochromatosis.
• Anthu omwe ali ndi matenda a chiwindi osatha, kuti aziwunikidwa nthawi ndi nthawi.

Kuyezetsa magazi pafupipafupi kwa munthu wopanda zizindikiro komanso wopanda zoopsa nthawi zambiri kumabweretsa zotsatira zosazolowereka zomwe zimapangitsa kuti apitirize kuyezetsa popanda phindu. Kambiranani ndi dokotala ngati mayesowo akuyankha funso lenileni kwa inu.

Zimene LFT singathe kuzizindikira kapena kuzichotsa

• LFT sipereka matenda. Kuchuluka kwa SGPT sikunena ngati chifukwa chake ndi mafuta, kachilombo, mankhwala kapena njira yodzitetezera ku matenda.
• LFT siimayesa fibrosis kapena cirrhosis. Anthu omwe ali ndi matenda a chiwindi omwe adziwika bwino nthawi zambiri amakhala ndi ma enzyme abwinobwino kapena pafupifupi abwinobwino. Kuchuluka kwa LFT sikuchotsa matenda a chiwindi omwe akukula.
• LFT sijambula chiwindi kapena ndulu. Miyala ya ndulu, miyala ya ndulu, ma cysts, abscess ndi zotupa sizimaoneka pa bolodi la magazi.
• LFT siiyesa khansa ya chiwindi. Kuyang'anira anthu omwe ali pachiwopsezo kumagwiritsa ntchito kujambula zithunzi, kaya ndi kapena ayi, monga momwe dokotala wa chiwindi amalangizira.
• Kutalika kwa enzyme sikufanana ndi kuuma kwake. ALT yokwera kwambiri imatha kuchitika mu chiwindi cha chiwindi chodziletsa; ALT yomwe ili pafupi ndi yachibadwa imatha kutsagana ndi matenda a chiwindi osabwezeretsedwa.
• Albumin ndi bilirubin wamba sizitsimikizira kuti ntchito yake ndi yabwino. matenda oyambirira, chifukwa izi zimasintha mochedwa.
• LFT siizindikira kachilombo kameneka. Matenda a chiwindi A, B, C ndi E amafunika mayeso osiyana a serological.

Zotsatira zomwe zafotokozedwa kuti "sizinazindikirike" kapena "zosapezeka" zimafotokoza zomwe zinayesedwa panthawiyo, sizikutanthauza kuti matendawo apitirirabe. Ngati zizindikiro zikupitirirabe ngakhale zotsatira zake zili bwino, pitani kwa dokotala.

Mayeso ofanana koma osiyana

Izi ndi zogwirizana, osati zolembedwa. Chomwe chimabwera poyamba chimadalira momwe chikuwonekera: jaundice yopanda ululu yokhala ndi kuyabwa komanso mawonekedwe a cholestatic nthawi zambiri imayambitsa kujambula kwa ndulu yotuluka m'magazi koyambirira; SGPT yokwera pang'ono yokhala ndi matenda a shuga komanso yopanda zizindikiro nthawi zambiri imayambitsa kuyezetsa kubwerezabwereza, kuwunikanso mankhwala ndi mowa, kuyezetsa chiwindi cha B ndi C ndi fibrosis score isanayambe china chilichonse.

Momwe mungakonzekerere

Kukonzekera ndi nkhani yogwira ntchito ndipo kumasiyana malinga ndi ma laboratories. Malangizo olembedwa a gawo lanu ndi ofunika kwambiri kuposa chilichonse apa.

• Kusala kudya nthawi zambiri sikofunikira pa LFT yokha. Ma laboratories ambiri aku India amaphatikiza LFT mu phukusi la thanzi lomwe lili ndi mafuta kapena shuga wosala kudya, ndipo ngati kuli koyenera kusala kudya, munthu angapemphedwe.
• Bweretsani mndandanda wonse wa mankhwala, kuphatikizapo mankhwala ochepetsa ululu, maantibayotiki, mankhwala opha mavairasi, mankhwala oletsa chifuwa chachikulu, ndi mankhwala onse azitsamba, AYUSH, ayurvedic, homeopathic ndi ma gym kapena ma supplements ochepetsa thupi.
• Uzani labotale za kumwa mowa posachedwapa, kuchita masewera olimbitsa thupi mwamphamvu kapena kuchita masewera olimbitsa thupi, matenda atsopano komanso mimba.
• Tengani malipoti am'mbuyomu a LFT. Zochitika pakapita nthawi nthawi zambiri zimakhala zophunzitsa zambiri kuposa mtengo umodzi.
• Musayambe, kusiya kapena kusintha mankhwala aliwonse omwe mwapatsidwa kuti "mukonze" zotsatira zake. Lankhulani ndi dokotala.

Ngati mukusala kudya ndipo mukumwa mankhwala ochepetsa shuga m'magazi

Kusala kudya nthawi yayitali kungayambitse kuchepa kwa shuga m'magazi mwa anthu omwe akumwa insulin kapena sulfonylureas. Funsani dokotala momwe mungasamalire mlingo m'mawa wosala kudya, lembani nthawi yoti mudye, komanso kukhala ndi shuga.

Pregnancy

ALP imakwera nthawi zambiri pa nthawi ya mimba chifukwa cha kupanga kwa placenta, kotero kuchuluka kwa ALP nthawi zambiri si vuto la chiwindi. Komabe, kuyabwa pa nthawi ya mimba pambuyo pake kumafunika kufufuzidwa mwachangu kuti mudziwe ngati pali cholestasis ya m'chiwindi. Nenani kuyabwa kwatsopano, jaundice, kupweteka kwambiri m'mimba, mutu kapena kusokonezeka kwa maso kwa dokotala wa ana nthawi yomweyo.

ana

ALP nthawi zambiri imakhala yokwera kwambiri mwa ana ndi achinyamata omwe akukula, ndipo nthawi zowerengera ana zimasiyana malinga ndi zaka. Zotsatira za ana ziyenera kutanthauziridwa molingana ndi msinkhu wawo ndi dokotala.

Akuluakulu, CKD ndi kulephera kwa mtima

Albumin imachepa ndi ukalamba, kutupa kosatha, kuchepa kwa mapuloteni a impso komanso kusadya bwino. Pakulephera kwa mtima, kutsekeka kwa chiwindi kumatha kukweza ma enzymes ndi bilirubin popanda matenda oyamba a chiwindi. Ngati muli ndi vuto la madzi m'thupi, musawonjezere kuchuluka kwa madzi m'thupi musanayesedwe magazi ndi upangiri wamba.

Chimachitika ndi chiyani panthawi ya mayeso

Dokotala wa phlebotomist amatsuka khungu, amapaka tourniquet ndikutulutsa magazi, nthawi zambiri kuchokera m'mitsempha ya m'manja. Kutulutsa magazi kumatenga mphindi zochepa. Kupweteka pang'ono, kuvulala kwakanthawi kapena kutuluka magazi pang'ono kumatha kuchitika; kukomoka sikwachilendo koma n'kotheka, choncho tchulani ngati mudakomokapo kale pa mayeso a magazi. Kupanikizika pamalopo kwa mphindi imodzi kapena ziwiri kumachepetsa kuvulala. Anthu ambiri amayambiranso kuchita zinthu wamba nthawi yomweyo. Anthu omwe ali ndi mankhwala ochepetsa magazi ayenera kusunga kuthamanga kwa magazi nthawi yayitali ndipo ayenera kuuza dokotala wa phlebotomist mankhwalawo.

Kumvetsa lipoti lanu

Werengani mndandanda wa maumboni a lipoti lanu. Manambala safanana m'ma laboratories osiyanasiyana. Mafunso othandiza ndi awa: ndi gulu liti la zinthu zomwe zakwezedwa, ndi kuchuluka kotani, ndipo zikusintha?

Kapangidwe ka maselo a chiwindi

SGPT/ALT ndi SGOT/AST zimawonjezeka mopitirira muyeso poyerekeza ndi ALP. Mayanjano ofala ndi monga matenda a chiwindi otchedwa steatotic, mowa, mankhwala ndi zowonjezera, matenda a chiwindi otchedwa virus (kuphatikizapo hepatitis E, omwe amapezeka kwambiri ku India), matenda a chiwindi otchedwa autoimmune, matenda a celiac, matenda a chithokomiro ndi matenda a Wilson mwa odwala achichepere.

Kapangidwe ka cholestatic

ALP ndi GGT zimakwezedwa mopitirira muyeso wa transaminases, nthawi zambiri zimakhala ndi bilirubin yokwera, mkodzo wakuda, ndowe zotumbululuka komanso kuyabwa. Zomwe zimayambitsa izi ndi miyala ya duct ya bile, strictures, zotupa zomwe zimakanikizira duct, cholestasis yomwe imabwera chifukwa cha mankhwala ndi primary biliary cholangitis. Kachitidwe kameneka nthawi zambiri kamabweretsa kujambula mtengo wa duct ya bile.

Bilirubin yokwera yokha

Ngati bilirubin yakwera pang'ono, makamaka yosalumikizana, ndipo zinthu zina zonse zili bwino mwa munthu wathanzi, matenda a Gilbert kapena kuchepa kwa magazi m'thupi ndi zifukwa zomwe zimafala. Kuchuluka kwa magazi m'thupi kumayesedwa ndi mayeso ena monga kuchuluka kwa ma reticulocyte ndi LDH.

ALP kapena GGT yokwezedwa yokha

Kukwera kwa ALP kokha kungakhale kochokera ku mafupa kapena ku placenta. Kukwera kwa GGT kokha sikuli kolunjika kwenikweni ndipo nthawi zambiri sikufunika kuchitapo kanthu kupatula kuwunikanso mowa ndi mankhwala, ndikubwereza kuyezetsa.

Albumin yotsika

Kuchepa kwa albumin m'thupi kungasonyeze matenda a chiwindi osatha komanso matenda oopsa, matenda opatsirana, matenda a nephrotic syndrome, matenda a m'matumbo omwe amataya mapuloteni kapena kusowa zakudya m'thupi. Kutanthauzira kumafuna chithunzi chachipatala.

Palibe nambala yomwe iyenera kuwerengedwa ngati matenda. Kutanthauzira ndi kwa dokotala amene adalamula mayeso, malinga ndi mbiri yanu, mankhwala ndi mayeso anu.

Pamene zotsatira za LFT zingakhale zosokeretsa

Kukwera kwa chiwindi molakwika kapena kosakhala kwa chiwindi

• AST: Kuchita masewera olimbitsa thupi kwambiri, kuchita masewera olimbitsa thupi, jakisoni wa m'mitsempha, matenda a minofu, kutuluka magazi m'chitsanzocho, komanso kuvulala kwa minofu ya mtima kapena mafupa kungawonjezere AST ngati chiwindi chili ndi thanzi labwino.
• ALP: mimba (yomwe ili m'chiberekero), kukula kwa ubwana ndi unyamata, kuchiritsa kusweka kwa mafupa ndi matenda a mafupa.
• Bilirubin: Kusala kudya kwa nthawi yayitali kapena matenda oopsa a Gilbert syndrome; haemolysis mu chubu cha chitsanzo; mankhwala ena omwe amasokoneza kugwira ntchito kwa bilirubin.
• GGT: mowa waposachedwa, mankhwala angapo ofala, kunenepa kwambiri, nthawi zambiri popanda matenda a chiwindi ofunikira kuchipatala.
• Kunyamulidwa mochedwa kapena chitsanzo choyezedwa magazi akhoza kukweza AST, bilirubin ndi potaziyamu molakwika; kubwerezabwereza kutengera zitsanzo kumathetsa kukayikira.

Kutonthoza molakwika kapena kutsika molakwika

• Ma enzyme abwinobwino m'matenda opita patsogolo: Mu matenda a cirrhosis, kuchuluka kwa ma enzyme nthawi zambiri kumatsika kufika pamlingo wabwinobwino pamene minofu ya chiwindi ikugwira ntchito bwino.
• ALT yachibadwa mu MASLD yofunika kwambiri yokhala ndi fibrosis ndi yofala, kotero LFT yachibadwa si njira yochotsera.
• AST/ALT imachepa chifukwa cha kusowa kwa vitamini B6 yafotokozedwa, ndipo imatha kuchepetsa kukwera kwa ma enzyme omwe amayembekezeredwa.
• Kuyesa kwa mfundo imodzi: Mlingo wa ma enzyme umasinthasintha mu matenda a chiwindi a C osatha komanso matenda a chiwindi a autoimmune, kotero kuwerenga kwabwinobwino tsiku limodzi kungalepheretse kuchita zinthu.
• Bilirubin ikhoza kukhala yachibadwa m'matenda ambiri osachiritsika a chiwindi omwe amayamba chifukwa cha kutsekeka kwa ndulu komanso matenda ambiri osatha a chiwindi.

Zoopsa ndi chitetezo

Kuyezetsa magazi

Kuboola m'mimba kumakhala ndi zoopsa zazing'ono: kupweteka, kuvulala, kutuluka magazi m'thupi, kufooka mutu, komanso matenda am'deralo kapena kuyabwa kwa mitsempha. Izi nthawi zambiri zimakhala zazing'ono komanso zosakhalitsa. Anthu omwe amamwa mankhwala oletsa magazi kapena omwe ali ndi vuto la kutuluka magazi ayenera kuuza ogwira ntchito pasadakhale.

Kujambula zithunzi zotsika

Ultrasound sigwiritsa ntchito ma radiation a ionizing. CT imakhudza kukhudzana ndi ma radiation ndipo ma iodine contrast sangakhale oyenera kwa anthu ena omwe ali ndi vuto la impso kapena ma contrast reaction omwe adachitika kale. MRI imafuna kuwunika chitetezo cha ma implants, pacemakers ndi zidutswa zachitsulo. Chilichonse mwa izi chili ndi mbiri yosiyana ya chiopsezo ndipo chimasankhidwa malinga ndi nkhani.

Chiwindi biopsy

Kufufuza za matenda a m'thupi ndi njira yolowerera yomwe ili ndi zoopsa kuphatikizapo kupweteka, kutuluka magazi, komanso, kawirikawiri, kuvulala kwa ziwalo zapafupi. Imasungidwa pazochitika zomwe matenda a minofu amasintha kasamalidwe, ndipo chilolezo chimaphatikizapo kukambirana za zoopsazi. Zotsatira zimasiyana malinga ndi momwe matenda amachitikira.

Zifukwa za LFTs zachilendo

• Matenda a chiwindi otchedwa Steatotic (SLD): mawu oyambira omwe adayambitsidwa mu mgwirizano wa Delphi wa 2023 (Rinella et al.). MASLD ilowa m'malo mwa NAFLD; MASH ilowa m'malo mwa NASH; MetalALD imafotokoza matenda a chiwindi a steatotic omwe amayambitsidwa ndi vuto la kagayidwe kachakudya omwe amakhudza kwambiri mowa. Matenda a chiwindi okhudzana ndi mowa ndi gulu losiyana.
• Viral hepatitis: Matenda a chiwindi a A ndi E (nthawi zambiri amakhala oopsa, ochokera m'madzi ndi m'zakudya, omwe amapezeka ku India), matenda a chiwindi a B ndi C (akhoza kukhala osatha komanso osamveka), matenda a chiwindi a D mwa anthu omwe ali ndi matenda a chiwindi a B.
• Matenda a chiwindi okhudzana ndi mowa, kuyambira pachiwindi chamafuta kupita ku chiwindi cha mowa mpaka ku matenda a chiwindi.
• Kuvulala kwa chiwindi chifukwa cha mankhwala ndi zowonjezera: paracetamol mu mankhwala owonjezera mphamvu ya mankhwala, mankhwala oletsa chifuwa chachikulu, maantibayotiki ena, mankhwala oletsa khunyu, methotrexate, ndi mankhwala owonjezera a zitsamba, ayurvedic ndi omanga thupi.
• Kutsekeka kwa ndulu: miyala ya ndulu mu duct ya ndulu, strictures, zotupa za pancreatic kapena biliary.
• Matenda a Autoimmune: matenda a chiwindi a autoimmune, cholangitis yoyamba ya biliary, cholangitis yoyamba ya sclerosing.
• Mikhalidwe yobadwa nayo: Matenda a Wilson, hemochromatosis yobadwa nayo, kusowa kwa alpha-1 antitrypsin, ndi matenda a Gilbert (osaopsa).
• Zifukwa zosakhala za chiwindi: kuvulala kwa minofu kapena myositis, matenda a celiac, matenda a chithokomiro, kulephera kwa mtima ndi kutsekeka kwa chiwindi, sepsis, haemolysis, matenda a kachilombo ka Epstein-Barr.
• Zotupa za chiwindi ndi metastases, ndi thumba la chiwindi.

Momwe ma LFT osazolowereka amayesedwa ndi kuchiritsidwa

Kasamalidwe ka matenda kamayang'ana chomwe chimayambitsa matendawa, osati chiwerengerocho. Njira yodziwika bwino imaphatikizapo mbiri yosamala ya mowa, mankhwala ndi zowonjezera; kufufuza; kubwereza LFT kuti mutsimikizire; kuyezetsa chiwindi cha B ndi C; kuyezetsa kagayidwe kachakudya kuphatikizapo shuga, HbA1c ndi mafuta; kuyezetsa kwa chithokomiro ndi coeliac komwe kuli kofunikira; mimba ya USG; ndi kuyezetsa kwa fibrosis ndi chiŵerengero monga FIB-4 kutsatiridwa ndi elastography komwe kwasonyezedwa. Ma antibodies a autoimmune, maphunziro achitsulo, maphunziro a mkuwa ndi caeruloplasmin amawonjezedwa pamene chitsanzocho chikuwonetsa. Biopsy imagwiritsidwa ntchito mosankha.

Chithandizo chimatsatira kuzindikiritsa: mankhwala oletsa mavairasi a chiwindi cha B kapena C chosatha, kupondereza chitetezo cha mthupi cha chiwindi cha autoimmune, chelation ya matenda a Wilson, venesection ya haemochromatosis, kutuluka kwa ndulu kapena opaleshoni yotsekeka, kuchotsa mankhwala oyambitsa kapena chowonjezera motsogozedwa ndi dokotala, kusiya kumwa mowa ndi chithandizo chokonzedwa bwino pamene mowa ukuthandiza, komanso MASLD kuphatikiza kusintha pang'onopang'ono kwa moyo, chithandizo cha matenda a shuga ndi lipids, ndi mankhwala atsopano otsogozedwa ndi chiwindi mwa odwala osankhidwa omwe ali pansi pa chisamaliro chapadera. Matenda a chiwindi omwe ali ndi vuto la chiwindi angayambitse kuwunika kwa kusamutsa ziwalo. Zotsatira zimasiyana kwambiri pakati pa anthu ndi pakati pa zomwe zimayambitsa.

Kuchepetsa kuvulala kwa chiwindi komwe kungapeweke

• Katemera wa matenda a chiwindi B, ndi matenda a chiwindi A komwe akulimbikitsidwa.
• Madzi akumwa abwino komanso ukhondo wa chakudya zimachepetsa kufalikira kwa matenda a chiwindi A ndi E.
• Funsani dokotala kapena wamankhwala musanagwiritse ntchito mankhwala enaake, mankhwala azitsamba kapena mankhwala ochepetsa ululu omwe amagulitsidwa musanayambe kumwa mankhwala, makamaka ngati muli ndi matenda a chiwindi.
• Sungani mlingo wa paracetamol womwe dokotala wanu akukulangizani, ndipo dziwani kuti mankhwala osakaniza ozizira alinso ndi paracetamol.
• Kuchita masewera olimbitsa thupi nthawi zonse, kuchiza matenda a shuga ndi mafuta m'thupi, komanso kuchepetsa kumwa mowa zonse zimachepetsa chiopsezo cha matenda a chiwindi otchedwa steatotic.
• Pitani kukaonana ndi dokotala mukalandira mankhwala oletsa chifuwa chachikulu kapena mankhwala ena ophera chiwindi.

Ma LFT Osazolowereka mu chikhalidwe cha India

• Terminology: Malipoti aku India nthawi zambiri amalemba transaminases SGPT ndi SGOT m'malo mwa ALT ndi AST. Onsewa amatchula ma enzyme omwewo. Kujambula zithunzi nthawi zambiri kumalembedwa kuti "USG mimba" kapena "sonography".
• Chiwindi cha Hepatitis E ndi A Matenda a hepatitis E nthawi zambiri amakhala chifukwa cha matenda a jaundice ku India ndipo nthawi zambiri amadziletsa okha, ngakhale kuti matenda a hepatitis E pa nthawi ya mimba amatha kukhala oopsa ndipo amafunika chithandizo chamankhwala mwachangu komanso kuchipatala.
• Chithandizo choletsa chifuwa chachikulu imagwiritsidwa ntchito kwambiri, ndipo kuvulala kwa chiwindi komwe kumachitika chifukwa cha mankhwala panthawi ya chithandizo ndi vuto lodziwika bwino. Musasiye kumwa ATT nokha, funsani dokotala mwamsanga ngati matenda a chikasu, kusanza kapena mkodzo wakuda akuwonekera.
• Zowonjezera za zitsamba, ayurvedic ndi masewera olimbitsa thupi ndi chifukwa chofala komanso chomwe nthawi zambiri sichinatchulidwe cha kuvulala kwa chiwindi. Bweretsani paketi yeniyeniyo ku nthawi yanu yokumana.
• Matenda a chiwindi omwe amakhudza kagayidwe kachakudya m'thupi pa BMI yotsika: Anthu aku South Asia amakhala ndi insulin resistance komanso chiwindi mafuta m'thupi lawo pamlingo wotsika wa thupi komanso m'chiuno, kotero munthu amene samawoneka wonenepa kwambiri akhoza kukhala ndi MASLD yofunikira.
• Khalidwe la Thalassemia ndi kuchepa kwa magazi m'thupi chifukwa cha kusowa kwa iron ndizofala; haemolysis ndi chitsulo chochuluka chokhudzana ndi kuikidwa magazi zimatha kukhudza mayeso a chiwindi ndi kafukufuku wa chitsulo.
• Maphukusi owunikira thanzi kumabweretsa ma LFT ambiri osazolowereka pang'ono. Vuto limodzi lochepa mwa munthu wathanzi nthawi zambiri limafuna kuwunikiranso ndikubwerezabwereza, osati mantha.
• Chitetezo cha data: Ngati mutumiza zambiri kudzera pa fomu iliyonse ya pa intaneti kapena tsamba lotsitsa malipoti, kusamalira deta yaumoyo wa munthu kumayendetsedwa ndi Digital Personal Data Protection Act, 2023.

Mtengo ndi inshuwalansi ku India

Chida choyezera magazi chodziwika bwino cha LFT ndi chimodzi mwa mayeso otsika mtengo a magazi ku India, nthawi zambiri amawononga ndalama zokwana mazana angapo a rupees m'mabungwe achinsinsi, ndipo maboma ndi mabungwe aboma nthawi zambiri amalipiritsa ndalama zochepa kapena osalipira kalikonse. Mitengo imakwera kwambiri pamene kafukufukuyu akufika pa matenda a chiwindi, ma autoimmune panels, maphunziro achitsulo ndi mkuwa, ultrasound, elastography, CT, MRI/MRCP kapena biopsy.

Zinthu zomwe zimakhudza mtengo:

• Mzinda ndi gulu la malo; Ma laboratories ovomerezeka ndi NABL poyerekeza ndi omwe sanavomerezedwe
• Kaya LFT ndi yodziyimira payokha kapena ndi gawo la phukusi loyang'anira thanzi
• Chiwerengero cha ma analyte omwe aphatikizidwa, ma panel ena "owonjezera" amawonjezera GGT, LDH kapena PT/INR
• Ndalama zotolera nyumba ndi kukonza mwachangu kapena pambuyo pa maola ola limodzi
• Kubwerezabwereza kuyesa ndi kuyang'anira pafupipafupi
• Kaya kujambula zithunzi kapena kufunsa kwa akatswiri kwawonjezeredwa

Khalidwe la inshuwalansi: Kuzindikira matenda akunja kwa odwala ndi kuwunika thanzi lodzitetezera nthawi zambiri kumachotsedwa mu inshuwaransi yazaumoyo yokhazikika ku India, pomwe mayeso omwewo omwe amachitidwa panthawi yolandila kapena njira yovomerezeka yosamalira ana nthawi zambiri amaphimbidwa. Kuphimba kumadalira mfundo za munthu payekha, nthawi yodikira ndi zigawo za matenda zomwe zilipo kale, tsimikizirani ndi kampani yanu ya inshuwalansi musanayese mayeso. Ziwerengero zonse pano ndi zongowonetsa zokha ndipo zimasintha malinga ndi malo, malo ndi nthawi; funsani chipatalacho kuti chikupatseni mtengo waposachedwa.

Nthano ndi mfundo zenizeni

MAFUNSO OFUNSIDWA KAWIRIKAWIRI

Kodi njira yonse ya LFT imatenga nthawi yayitali bwanji?

Kutenga magazi kokha kumatenga mphindi zochepa, ndipo ulendo wopita kuchipatala kuphatikizapo kulembetsa ndi kudikira nthawi zambiri umatenga mphindi 15-30. Nthawi yokonza labu ndi kutulutsa lipoti zimasiyana malinga ndi malo ogwirira ntchito ndipo zimadalira ngati chitsanzocho chimayendetsedwa nthawi zonse kapena mwachangu, choncho funsani malo anu osonkhanitsira magazi kuti akupatseni nthawi yake.

Kodi ndiyenera kusala kudya kuti ndione ngati chiwindi changa chili bwino?

Kusala kudya nthawi zambiri sikofunikira pa LFT yokha. Mapaketi ambiri azaumoyo aku India amaphatikiza LFT ndi shuga kapena mafuta osala kudya, ndipo kusala kudya kungapemphedwe. Tsatirani malangizo olembedwa a labotale yanu. Ngati mutenga insulin kapena sulfonylureas, funsani dokotala wanu momwe mungasamalire mlingo m'mawa wosala kudya.

Kodi SGPT ndi yofanana ndi ALT, ndipo SGOT ndi yofanana ndi AST?

Inde. SGPT ndi ALT ndi enzyme yomweyi yomwe ili ndi mayina awiri, monga momwe zilili ndi SGOT ndi AST. Ma laboratories aku India nthawi zambiri amasindikiza zilembo za SGPT ndi SGOT. ALT imagwirizana kwambiri ndi chiwindi; AST imachokeranso ku minofu, mtima ndi maselo ofiira a magazi, kotero AST imatha kukwera popanda vuto lililonse la chiwindi.

SGPT yanga yakwera pang'ono koma ndikumva bwino kwambiri. Kenako, ndi chiyani?

Kukwera pang'ono kwa magazi m'thupi ndi kofala. Njira zina zodziwika bwino ndi kuwunikanso mankhwala ndi zowonjezera, mbiri ya mowa, kuyezetsanso pambuyo pa milungu ingapo popewa kuchita masewera olimbitsa thupi kwambiri musanayambe, kuyezetsa chiwindi cha B ndi C, kuyezetsa kagayidwe kachakudya m'thupi, ndi chiŵerengero cha fibrosis. Dokotala wanu amasankha njira yotsatizana ndi zoopsa zomwe muli nazo.

Kodi masewera olimbitsa thupi kapena zakudya zina zolimbitsa thupi zimawonjezera ma enzymes a chiwindi?

Inde. Kulimbitsa thupi kwambiri kungakweze AST ndipo, osati ALT kuchokera ku minofu osati chiwindi. Mosiyana, zowonjezera zingapo zolimbitsa thupi ndi kuchepetsa thupi zayambitsa kuvulala kwenikweni kwa chiwindi. Uzani dokotala wanu za mankhwala onse omwe agwiritsidwa ntchito, makamaka kubweretsa paketi, ndikutchula masewera olimbitsa thupi omwe achitika posachedwapa musanayese.

Kodi kuchuluka kwa bilirubin nthawi zonse kumatanthauza matenda a chiwindi kapena chikasu?

Ayi. Kuchuluka kwa bilirubin yosalumikizidwa bwino yomwe imakhala ndi miyeso yabwinobwino mwa munthu wathanzi nthawi zambiri imasonyeza matenda a Gilbert, matenda osavulaza omwe amabadwa nawo omwe amaonekera kwambiri ndi kusala kudya kapena matenda. Kuchepa kwa magazi m'thupi ndi chifukwa china. Kuchuluka kwa bilirubin m'magazi nthawi zambiri kumafuna kuchuluka kwa bilirubin ndipo kumafuna kuunikanso kwa dokotala mwachangu.

Kodi ma LFT osazolowereka angabwererenso kuzinthu zachilendo?

Kawirikawiri, inde, pamene vuto lotha kusintha monga mankhwala, zowonjezera, mowa kapena matenda a chiwindi oopsa a kachilomboka lathetsedwa, ndipo nthawi zambiri ndi kusintha kwa kagayidwe kachakudya mu MASLD. Matenda a chiwindi omwe adakhazikika sabwerera m'mbuyo, ngakhale kuti kupita patsogolo nthawi zambiri kumatha kuchepetsedwa. Zotsatira zimasiyana malinga ndi momwe matenda amachitikira.

Kodi ultrasound ndi yabwino kuposa LFT?

Palibe chomwe chili chabwino kuposa ichi; chimayankha mafunso osiyanasiyana. LFT imasonyeza ngati pali kuvulala kwa biochemical kapena kutsekeka ndipo ndi mtundu wanji. Ultrasound imasonyeza kapangidwe kake, mafuta, kukula kwake, ma nodularity, miyala ya ndulu, kukula kwa duct. Ultrasound singathe kuwona kutupa ndipo singaphonye steatosis yofatsa ndi miyala yaing'ono ya duct ya ndulu.

Kodi banja langa liyenera kuyezedwa ngati ndili ndi matenda a chiwindi otchedwa hepatitis B?

Anthu apabanja ndi ogonana nawo a munthu amene ali ndi matenda a chiwindi B nthawi zambiri amalangizidwa kuti ayezedwe, ndipo ngati sali ndi chitetezo chokwanira, alandire katemera. Makanda obadwa kumene a amayi omwe ali ndi matenda a chiwindi B amafunika njira zinazake panthawi yake. Kambiranani ndi dokotala za mapulani oyezetsa ndi katemera.

magwero

• Rinella ME, ndi ena. Chiganizo cha mgwirizano wa anthu ambiri cha Delphi pa mayina atsopano a matenda a chiwindi chamafuta (2023), chimatanthauzira matenda a chiwindi a steatotic, MASLD, MASH ndi MetalALD.
• Malangizo a zachipatala a American College of Gastroenterology pakuwunika kwa mankhwala osazolowereka a chiwindi. [Tsimikizirani kope lamakono, KUTI LITSIMIKIZIDWE]
• Malangizo a EASL okhudza matenda a chiwindi a cholestatic komanso mayeso osavulaza odwala kuti awone kuopsa kwa matenda a chiwindi. [Tsimikizirani kope lamakono, KUTI LITSIMIKIZIDWE]
• Malangizo a World Health Organization pa kuyezetsa ndi kuchiza matenda a chiwindi B ndi chiwindi C. [Tsimikizirani kope lamakono, KUTI LITSIMIKIZIDWE]
• Pulogalamu Yoyang'anira Matenda a Chiwindi ya Dziko Lonse, Unduna wa Zaumoyo ndi Ubwino wa Mabanja, Boma la India.
• Lamulo la Chitetezo cha Deta Yaumwini pa Intaneti, 2023; Lamulo la Mankhwala Osokoneza Bongo ndi Zamatsenga (Zotsatsa Zosaloledwa), 1954.