Miedzo yeKushanda Kwechiropa Zvisina Kunaka (LFT): Zvinoreva Zvinoguma Zvaitika, Zvinokonzera uye Matanho Anotevera

Key tora kutora

• Kurwara neLFT kusingawanzoitiki chiratidzo, kwete kuongororwa. Nhamba dzakafanana dzinogona kubva pachiropa chine mafuta, hutachiona, mushonga kana chimwe chinhu chisiri chiropa.
• Patani yacho inokosha kupfuura chero nhamba imwe chete. Mapatani emasero eropa (ALT/AST-dominant) uye echolestatic (ALP/GGT/bilirubin-dominant) anonongedzera mativi akasiyana.
• MaLFT akajairwa haabvisi chirwere chechiropa. Kurwara kweropa (cirrhosis) uye fibrosis huru zvinogona kuitika nema enzymes akajairwa.
• Zvimwe zvinhu zvisingawanzoitiki zvinokurumidza kuitika. Jaundice ine kuvhiringidzika, hope kana kubuda ropa inoda kuongororwa nekukurumidza.
• Kudzokorora bvunzo kazhinji ndiyo nhanho inotevera yakakodzera, uye dudziro ndeyachiremba akakumbira bvunzo. Mhedzisiro inosiyana zvichienderana nemamiriro ezvinhu ekurapa emunhu mumwe nemumwe.

Pakuona

Uyewo anozivikanwa se

• LFT, chiropa, chimiro chechiropa, kemesitiri yechiropa, chiropa chinoshanda
• Bvunzo reSGPT neSGOT, mazita ezuva nezuva echiIndia eALT neAST
• "Kuongororwa kwechiropa", "kuongororwa kweropa rechiropa", "kuongororwa kwejaundice" (kunotarisa bilirubin)
• Mazwi echivanhu: liver ki jaanch, bvunzo ye peelia
• Cherechedza: "kuyedzwa kwebasa rechiropa" izita rekare. Zvikamu zvakawanda zvinoyera kukuvara kwechiropa kana kuyerera kwenyongo panzvimbo pekushanda chaiko.

Chii chinonzi LFT chisina kujairika

Chiropa chinopa huwandu hwezviyero zvisina hukama pamwe chete. Chimwe nechimwe chinoita zvakasiyana:

• SGPT/ALT uye SGOT/AST ma enzyme anoburitswa kana masero echiropa akakuvara. AST inobvawo mutsandanyama, mwoyo nemasero matsvuku eropa, saka AST inogona kukwira pasina chirwere chechiropa.
• KUNA P Inokwira nedambudziko remutsinga wenyongo, asi inobvawo mumapfupa, placenta neura. Vana vari kukura nepamuviri vanowanzoratidza ALP yakakwira.
• GGT kuwedzera inobatwa nechirwere asi haisi chaiyo. GGT inokwira nedoro, mishonga yakawanda nechiropa chine mafuta, uye GGT yakakwira yoga hairevi zvakawanda.
• Bilirubin Inokwira kana bile risingashande zvakanaka, duct yebile ikavharika, kana kuti masero matsvuku akaputsika (hemolysis). Gilbert syndrome inokonzera kukwira kusingakuvadzi, kusingasanganisike, kazhinji kunoonekwa mushure mekutsanya kana kurwara.
• Albumin uye mapuroteni ese zvinoratidza kugadzirwa kwemasero, asiwo zvinovaka muviri, kuzvimba, kurasikirwa nemapuroteni muitsvo uye kurasikirwa nematumbu.
• PT/INR (inowanzo rairwa yoga) ndeimwe yezviratidzo zvishoma zvechokwadi zvekushanda kwechiropa.

Mureza "usina kujairika" pamushumo unoreva kuti kukosha kuri kunze kwechikamu chereferensi chemurabhoritari iyoyo. Nguva dzereferensi dzinosiyana pakati pemarabhoritari nenzira, analyzer uye huwandu hwevanhu, ndosaka ropa rimwe chete richigona kuratidzwa murabhoritari imwe kwete mune imwe. Gara uchiverenga huwandu hwakadhindwa pamushumo wako pane kuenzanisa nehwemumwe munhu.

Nei LFTs dzisina kujairika dzichiongororwa

• Kuparadzanisa zvikonzero zvechiropa kubva kune zvisiri zvechiropa zvakaita sekukuvara kwetsandanyama, chirwere chethyroid, chirwere checoeliac, kutadza kushanda kwemoyo kana kubuda ropa mumuviri.
• Kuziva zvikonzero zvinorapika: hepatitis B naC, hepatitis inorwisa muviri, chirwere cheWilson, haemochromatosis, kukuvara kwechiropa kunokonzerwa nemishonga, kuvharika kwemugero we bile.
• Kuona chirwere chechiropa chinonzi steatotic liver disease (MASLD), izwi riri kutsiva NAFLD, uye kutsvaga fibrosis, inova ndiyo inonyanya kukanganisa mhedzisiro yenguva refu.
• Kuona kuoma kwechirwere kana paine jaundice, ascites kana kuvhiringidzika.

Ndiani anofanira kuongororwa mashandiro echiropa

• Munhu wese ane jaundice, weti yakasviba, tsvina isina kujeka, kuvaviwa kunogara kuripo, kurwadziwa mudumbu rekumusoro kurudyi, kuda kurutsa kusingatsananguriki kana kuneta kwakanyanya.
• Vanhu vane kuzvimba mudumbu, vane mavanga ari nyore kana kurutsa ropa, nekukurumidza.
• Vanhu vane chirwere cheshuga cherudzi rwechipiri, insulin resistance, dyslipidemia, BP kana central weight gain, vane chirwere chechiropa chinonzi steatotic liver disease. MuSouth Asia, chirwere chechiropa chinokonzerwa nemetabolism chinoitika pahuwandu hwakaderera hwemuviri kupfuura mune dzimwe nzvimbo dzakawanda.
• Vanhu vari kutora mishonga inogona kukuvadza mapapu kana chiremba akavapa zano rekutarisa, semuenzaniso mushonga wekurwisa TB, methotrexate, mimwe mishonga yekurwisa pfari, mishonga yefungal, uye mimwe mishonga yekudzivirira chirwere. Nguva dzekutarisa dzinogadzwa nemupi wemishonga.
• Vanhu vanoshandisa mishonga yeAYUSH, mishonga yemishonga yemishonga, yekuderedza uremu kana yekurovedza muviri, izvo zvinozivikanwa uye zvisingataurwi zvakanyanya kukonzera kukuvara kwechiropa kunokonzerwa nemishonga muIndia.
• Vanhu vanoshandisa doro nguva dzose kana kuti vanoshandisa doro zvakanyanya.
• Vanhu vane hepatitis B kana C, kana nhengo yemhuri ine hepatitis B, uye avo vane nhoroondo yemhuri yechirwere chechiropa, chirwere cheWilson kana haemochromatosis.
• Vanhu vane chirwere chechiropa chisingaperi chinozivikanwa, kuti vatariswe nguva nenguva.

Kuongororwa kweLFT nguva dzose kumunhu asina zviratidzo uye asina njodzi kunowanzo buritsa mhedzisiro isina kujairika iyo inotungamira kune kumwe kuongororwa pasina rubatsiro. Kurukura nachiremba kana bvunzo yacho ichipindura mubvunzo chaiwo kwauri.

Izvo LFT isingakwanise kuona kana kusabvisa

• LFT haipe chirwere chepfungwa. SGPT yakakwira haitauri kana chikonzero chiri mafuta, hutachiona, mushonga kana maitiro ekudzivirira muviri.
• LFT haipime fibrosis kana cirrhosis. Vanhu vane chirwere checirrhosis vanowanzova nema enzymes akajairwa kana kuti anenge akajairika. Kutora LFT yakajairwa hakubvisi chirwere chechiropa chakanyanya kukura.
• LFT haioni chiropa kana ducts dze bile. Matombo emunduru, matombo emutsinga wenyongo, mavanga, mabundu uye mapundu hazvionekwe paropa.
• LFT haiongorori kenza yechiropa. Kuongororwa kwevanhu vari panjodzi kunoshandisa mifananidzo, ine kana isina AFP, sezvinorayirwa nachiremba wehepatologist.
• Kureba kwema enzyme hakuenzani nekuoma kwayo. ALT yakakwira zvikuru inogona kuitika muhepatitis inozviganhurira; ALT inenge yakajairika inogona kuperekedzwa nedecompensated cirrhosis.
• Albumin yakajairika uye bilirubin hazvisimbise mashandiro akanaka mukutanga kwezvirwere, sezvo izvi zvichichinja kunonoka.
• LFT haizivi hutachiona chaihwo. Hepatitis A, B, C naE zvinoda bvunzo dzakasiyana dzeropa.

Mhedzisiro inotsanangurwa se "isina kuzivikanwa" kana "iri pakati penzvimbo" inotsanangura zvakayerwa panguva iyoyo, haibvisi chirwere. Kana zviratidzo zvikaramba zviripo pasinei nemhedzisiro yakajairika, dzokera kuna chiremba wako.

Bvunzo dzakabatana asi dzakasiyana

Izvi zvinopindirana, hazvitaurwi. Kuti ndechipi chinotanga zvichienderana nechiratidzo: jaundice isingarwadzi ine kuvaviwa uye patani yecholestatic inowanzo kurudzira kutorwa kwemifananidzo yemudumbu uri mudumbu nekukurumidza; SGPT yakakwira zvishoma ine chirwere cheshuga uye isina zviratidzo inowanzo kurudzira kuongororwazve, kuongororwa kwemishonga nedoro, kuongororwa kwehepatitis B neC uye fibrosis score isati yasvika chero chimwe chinhu.

Maitiro ekugadzirira

Kugadzirira inyaya yekushanda uye inosiyana zvichienderana nemarabhoritari. Mirayiridzo yakanyorwa yeyuniti yako ndiyo inonyanya kukosha pane chero chinhu pano.

• Kutsanya kazhinji hakudiwi kune munhu ane LFT chete. Marabhoritari mazhinji ekuIndia anounganidza LFT mupakeji yehutano ine mafuta kana shuga yekutsanya, uye kana zvakadaro kutsanya kunogona kukumbirwa.
• Uyai nerunyorwa rwakazara rwemishonga, kusanganisira mishonga inoderedza marwadzo, mishonga inorwisa mabhakitiriya, mishonga inouraya fungus, mishonga inorwisa TB, pamwe nemishonga yese yemishonga, AYUSH, ayurvedic, homeopathic uye mishonga yekurovedza muviri kana yekuderedza uremu.
• Udza rabhoritari nezvekunwa doro kwawakaita nguva pfupi yadarika, kurovedza muviri kwawakaita nesimba kana kuita basa rekurovedza muviri, kurwara kwawakaita nguva pfupi yadarika uye pamuviri.
• Takura mishumo yekare yeLFT. Mafambiro nekufamba kwenguva anowanzo ratidza ruzivo kupfuura kukosha kumwe chete.
• Usatange, usamise kana kuchinja chero mushonga wawakanyorerwa kuti "uvandudze" mhedzisiro. Taura neanokupa mushonga.

Kana uchitsanya uye uchitora mishonga inoderedza shuga yeropa

Kutsanya kwenguva refu kunogona kukonzera hypoglycemia kuvanhu vanotora insulin kana sulfonylureas. Bvunza chiremba kuti ungatora sei mishonga mangwanani ekutsanya, bhuka nguva yekutsanya, uye kutakura shuga.

Kuberekwa

ALP inokwira zvakanyanya panguva yekuzvitakura nekuda kwekuumbwa kweplacenta, saka kuwedzera kweALP kazhinji hakusi dambudziko rechiropa. Zvisinei, kuvaviwa panguva yekuzvitakura, kunoda kuongororwa nekukurumidza kana paine cholestasis yekuzvitakura mukati mehepatic. Taura nezvekuvaviwa kutsva, jaundice, kurwadziwa kwakanyanya kwedumbu rekumusoro, musoro kana matambudziko ekuona kuna chiremba wezvekubereka nekukurumidza.

Children

ALP inowanzo kuve yakakwira zvakanyanya muvana vari kukura nevachiri kuyaruka, uye nguva dzekuongororwa kwevana dzinosiyana zvichienderana nezera. Mhedzisiro yevana inofanira kutsanangurwa zvichienderana nezera ravo nachiremba wevana.

Vakuru, CKD uye kutadza kwemoyo

Albumin inoderera nekukura, kuzvimba kwenguva refu, kurasikirwa nemapuroteni eitsvo uye kusadya zvakanaka. Mukushaya simba kwemoyo, kuzara kwechiropa kunogona kuwedzera ma enzymes uye bilirubin pasina chirwere chechiropa chikuru. Kana uine dambudziko remvura, usawedzera mvura inonwiwa usati waongororwa ropa uchishandisa zano rechiremba.

Chii chinoitika panguva yebvunzo

Chiremba wephlebotomist anochenesa ganda, anoisa tourniquet uye anotora ropa, kazhinji kubva mutsinga iri muruoko. Kudhonza kunotora maminetsi mashoma. Kurwadziwa kudiki, mavanga madiki kana kubuda ropa diki kunogona kuitika; kupera simba hazviwanzoitiki asi zvinogoneka, saka taura nezvazvo kana wakambofenda pakuongororwa ropa kare. Kumanikidzwa panzvimbo iyi kwemaminitsi maviri kunoderedza mavanga. Vanhu vazhinji vanotangazve kuita mabasa avo enguva dzose ipapo ipapo. Vanhu vane mishonga yekuderedza ropa vanofanira kuchengetedza BP kwenguva yakareba uye vanofanira kuudza chiremba wephlebotomist nezvemushonga wacho.

Kunzwisisa mushumo wako

Verenga magwaro ekuongorora emushumo wako. Nhamba hadzina kuenzana muma laboratories. Mibvunzo inobatsira ndeiyi: ndeipi boka rezvinhu zvinowedzerwa, zvakadii, uye zviri kuchinja here?

Maitiro emasero eropa

SGPT/ALT uye SGOT/AST zvakasimudzwa zvisina kuenzana neALP. Masangano akajairika anosanganisira chirwere chechiropa chinonzi steatotic, doro, mishonga nezvimwe zvinowedzera, hepatitis yehutachiona (kusanganisira hepatitis E, iyo inowanikwa muIndia), hepatitis ye autoimmune, chirwere checoeliac, matambudziko ethyroid uye chirwere cheWilson muvarwere vadiki.

Maitiro eCholestatic

ALP neGGT zvinokwidzwa zvisina kuenzana ne transaminases, kazhinji ne bilirubin yakakwira, weti yakasviba, tsvina isina kujeka uye kuvaviwa. Zvikonzero zvinosanganisira matombo emugero we bile, strictures, bundu rinodzvanya mugero, cholestasis inokonzerwa nemishonga uye primary biliary cholangitis. Maitiro aya anowanzo tungamira kumifananidzo yemuti we nyongo.

Bilirubin yakakwira yakaparadzaniswa

Kana bilirubin yakakwira zvishoma, kazhinji isina kubatana, uye zvimwe zvese zviri zvakajairika mumunhu akagwinya, chirwere cheGilbert kana hemolysis iri nyore ndizvo zvinowanzo tsanangurwa. Hemolysis inoongororwa nemimwe miedzo yakadai se reticulocyte count uye LDH.

ALP kana GGT yakasimudzwa iri yoga

Kukwira kweALP kunongobva pamapfupa kana padumbu. Kukwira kweGGT kunongobva pamapfupa chete uye hakudi kutorwa matanho kunze kwekunge kuongororwa kwedoro nemishonga, uye kuongororwazve.

Albumin yakaderera

Kuderera kwealbumin mumuviri kunogona kuratidza chirwere chechiropa chisingaperi asiwo kurwara zvakanyanya, hutachiona, nephrotic syndrome, chirwere chedumbu chinorasikirwa nemapuroteni kana kushaya kudya kwakakwana. Kududzira kunoda mufananidzo wekiriniki.

Hapana nhamba pano inofanira kuverengwa sechirwere. Dudziro ndeyachiremba akarayira bvunzo, zvichienderana nenhoroondo yako, mishonga yako uye kuongororwa kwako.

Kana mhedzisiro yeLFT inogona kutsausa

Kukwidziridzwa kweropa zvisina kururama kana kuti kusina kukwira kweropa

• AST: kurovedza muviri kwakaoma, kurovedza muviri, kubaiwa jekiseni remutsinga, chirwere chetsandanyama, kubuda ropa muropa, uye kukuvara kwetsandanyama dzemwoyo kana dzemapfupa zvinogona kuwedzera AST nechiropa chine hutano.
• ALP: pamuviri (placenta), kukura kwevana nevekuyaruka, kuporesa kutyoka kwemapfupa uye chirwere chemapfupa.
• Bilirubin: kutsanya kwenguva refu kana kurwara zvakanyanya muchirwere cheGilbert syndrome; hemolysis muchubhu yemuenzaniso; mimwe mishonga inovhiringidza kubata bilirubin.
• GGT: doro razvino, mishonga yakawanda yakajairika, kufuta, kazhinji pasina chirwere chechiropa chakakosha.
• Kutakurwa kwanonoka kana kuti sampuli yakabviswa ropa inogona kukwidza AST, bilirubin uye potassium zvisina tsarukano; kudzokorora kutora sampu kunogadzirisa kusava nechokwadi.

Kunyepedzera kunyaradza kana kudzikiswa kwenhema

• Ma enzymes akajairika muzvirwere zvakanyanya: muchirwere checirrhosis, huwandu hweenzymes hunowanzo derera kusvika pahwakajairika sezvo tishu dzechiropa dzichishanda zvishoma nezvishoma.
• ALT yakajairika muMASLD yakakosha ine fibrosis zvakajairika, saka LFT yakajairika haisi clearance.
• AST/ALT inoderedzwa nekushomeka kwevhitamini B6 inotsanangurwa, uye inogona kudzikamisa kukwira kwema enzyme anotarisirwa.
• Kuedzwa kwepoinzi imwe chete: mazinga ema enzyme anochinja-chinja muhepatitis C isingaperi uye autoimmune hepatitis, saka kuverenga kwakajairika pazuva rimwe chete kunogona kutadza kuita chimwe chinhu.
• Bilirubin inogona kuva yakajairika mukutanga kwekuvharika kwenzira yemudumbu uye muzvirwere zvakawanda zvechiropa zvisingaperi.

Njodzi nekuchengetedzeka

Kuongororwa kweropa

Kuboorwa kweropa muropa kune njodzi diki: kurwadziwa, mavanga, kubuda ropa mumuviri, kuchembera, uye kazhinji hutachiona hwepanzvimbo kana tsinga dzinorwadza. Izvi zvinowanzova zvidiki uye zvinogara kwenguva pfupi. Vanhu vanonwa mishonga inorwisa ropa kana vane matambudziko ekubuda ropa vanofanira kuudza vashandi vavo nguva isati yasvika.

Mifananidzo iri pasi pemvura

Ultrasound haishandisi mwaranzi ionizing. CT inosanganisira kuratidzwa kwemwaranzi uye iodine contrast inogona kusakodzera vamwe vanhu vane dambudziko reitsvo kana kuti vane contrast reactions dzakamboitika. MRI inoda kuongororwa kwakachengeteka kwezvishandiso zveimplants, pacemakers uye zvidimbu zvesimbi. Chimwe nechimwe chezvizvi chine njodzi yakasiyana uye chinosarudzwa zvichienderana nemamiriro ezvinhu.

Chiropa biopsy

Kuongororwa kwemuviri inzira yekurapa ine njodzi dzinosanganisira kurwadziwa, kubuda ropa, uye, kashoma, kukuvara kwezvivako zviri pedyo. Inochengeterwa mamiriro ezvinhu apo kuongororwa kwenyama kunochinja manejimendi, uye mvumo inosanganisira kukurukura nezvenjodzi idzi. Mhedzisiro inosiyana zvichienderana nemamiriro ekurapa emunhu mumwe nemumwe.

Zvikonzero zveLFTs dzisina kujairika

• Chirwere chechiropa chinonzi Steatotic liver disease (SLD): Izwi rekuti "amburera" rakaunzwa muDelphi consensus ye2023 (Rinella et al.). MASLD inotsiva NAFLD; MASH inotsiva NASH; MetalALD inotsanangura chirwere chechiropa chinonzi steatotic dysfunction chinokonzerwa nekushaya simba kwemetabolism uye ine mupiro wakakura wedoro. Chirwere chechiropa chine chekuita nedoro iboka rakasiyana.
• Viral hepatitis: hepatitis A naE (kazhinji inopararira mumvura uye muchikafu, inowanikwa muIndia), hepatitis B naC (inogona kuva isingaperi uye isinganyanyi kuitika), hepatitis D kune avo vane hepatitis B.
• Chirwere chechiropa chinokonzerwa nedoro, kubva pachiropa chine mafuta akawanda kusvika pahepatitis ine doro kusvika pacirrhosis.
• Kukuvadzwa kwechiropa kunokonzerwa nemishonga nezvimwe zvinowedzera: paracetamol inoshandiswa mukunwa zvinodhaka zvakanyanya, mishonga yekurwisa TB, mimwe mishonga inorwisa mabhakitiriya, mishonga yekurwisa pfari, methotrexate, uye mishonga yemishonga, yeAyurvedic uye yekuvaka muviri.
• Kuvharika kwenyongo: matombo emunduru mudura renyongo, zvidimbu, tumapundu twepancreas kana nyongo.
• Autoimmune mamiriro: chirwere che autoimmune hepatitis, chirwere chekutanga che biliary cholangitis, chirwere chekutanga che sclerosing cholangitis.
• Mamiriro ekugara nhaka: Chirwere cheWilson, hemochromatosis yenhaka, kushaya alpha-1 antitrypsin, Gilbert syndrome (isina njodzi).
• Zvikonzero zvisiri zvechiropa: kukuvara kwetsandanyama kana myositis, chirwere checoeliac, chirwere chethyroid, kutadza kwemoyo pamwe nekuzara kwechiropa, sepsis, haemolysis, hutachiona hweEpstein-Barr.
• Matumbu echiropa uye metastases, uye dumbu rechiropa.

Maitiro ekuongorora uye kurapwa kweLFTs dzisina kujairika

Kutarisira chirwere kunotarisa chikonzero, kwete nhamba yacho. Nzira yakajairika inosanganisira nhoroondo yekunyatsoongorora doro, mishonga nezvimwe zvinovaka muviri; kuongororwa; kudzokorora LFT kuti usimbise; kuongororwa kwehepatitis B neC; kuongororwa kwemetabolism kunosanganisira glucose, HbA1c uye lipids; kuongororwa kwethyroid necoeliac pazvinenge zvakakodzera; USG dumbbell; uye kuongororwa kwefibrosis neFIB-4 ichiteverwa ne elastography pazvinenge zvaratidzwa. Ma antibodies e autoimmune, zvidzidzo zvesimbi, zvidzidzo zve copper uye caeruloplasmin zvinowedzerwa kana patani yacho ichiratidza kuti ndizvo zviri kuitika. Biopsy inoshandiswa nenzira yekusarudza.

Kurapa kunotevera kuongororwa: kurapwa kwehutachiona hwehepatitis B kana C isingaperi, kudzvinyirirwa kwemuviri kwehepatitis ye autoimmune, chelation yechirwere cheWilson, venesection ye haemochromatosis, kubuda kwemvura muchubhu kana kuvhiyiwa kwekuvhara, kubvisa mushonga kana chiwedzerwa chemushonga pasi pekutungamirirwa nachiremba, kurega kunwa doro nerutsigiro rwakarongeka apo doro riri kukonzera, uye MASLD musanganiswa wekuchinja mararamiro zvishoma nezvishoma, kurapwa kwechirwere cheshuga nemafuta, uye mishonga mitsva inotungamirirwa nechiropa muvarwere vakasarudzwa vari pasi pekutarisirwa kwachiremba. Cirrhosis yakakwira ine kutadza kwechiropa inogona kutungamira mukuongororwa kwekuisirwa ropa. Mhedzisiro inosiyana zvakanyanya pakati pevanhu uye pakati pezvikonzero.

Kuderedza kukuvara kwechiropa kunodzivirirwa

• Kubaiwa nhomba yehepatitis B, uye hepatitis A kana zvichikurudzirwa.
• Mvura yekunwa yakachengeteka uye hutsanana hwezvekudya zvinoderedza mukana wekuti munhu abatwa nechirwere chehepatitis A neE.
• Bvunza chiremba kana wemishonga usati watanga chero mushonga wekuwedzera, mishonga yemiti kana mushonga wekuderedza marwadzo unotengwa nechiremba, kunyanya kana uine chirwere chechiropa.
• Chengeta mukati memuyero weparacetamol waunorayirwa nachiremba, uye ziva kuti mishonga inosanganiswa yechando inewo paracetamol.
• Kugara uchiita maekisesaizi, kurapa chirwere cheshuga nemafuta, uye kuderedza kunwa doro zvese zvinoderedza njodzi yekuwedzera kwechirwere chechiropa chinonzi steatotic liver disease.
• Enda kunoongororwa ropa panguva yekurapwa nechirwere cheTB kana kumwe kukuvadza kweropa.

MaLFT asina kujairika mumamiriro ezvinhu eIndia

• Terminology: Mishumo yeIndia inowanzo nyora ma transaminases eSGPT neSGOT pane ALT neAST. Ose ari maviri anotsanangura ma enzymes akafanana. Mifananidzo inowanzo nyorwa se "USG abdominal" kana kuti "sonography".
• Hepatitis E neA Chirwere ichi chinoramba chiri chikonzero chinowanzoitika chejaundice muIndia uye chinowanzozviganhurira, kunyange hazvo hepatitis E panguva yekuzvitakura inogona kuva yakanyanya uye inoda rubatsiro rwekubatsirwa nepamuviri nekubatsirwa kwechiremba nekukurumidza.
• Kurapa kwechirwere cheTB inoshandiswa zvakanyanya, uye kukuvara kwechiropa kunokonzerwa nemishonga panguva yekurapwa idambudziko rinozivikanwa. Usamborega kushandisa ATT uri wega, taura nachiremba ari kurapa nekukurumidza kana jaundice, kurutsa kana weti yakasviba zvikaonekwa.
• Mishonga, Ayurvedic uye zvekuwedzera zvekurovedza muviri ndizvo zvinowanzokonzera kukuvara kwechiropa uye hazviwanzotaurwa. Uya nepaketi chaiyo kumusangano wako.
• Chirwere chechiropa chemuviri chiri paBMI yakaderera: Vanhu vekuSouth Asia vanokura vasingadi insulin uye mafuta echiropa padanho repasi remuviri uye muchiuno, saka munhu asingaratidzike seakafuta anogona kuramba aine MASLD yakakura.
• Zviratidzo zveThalassemia uye anemia yekushaikwa kwesimbi zvinowanzoitika; kubuda kweropa mumuviri uye kuwedzerwa kwesimbi kunogona kukanganisa kuongororwa kwechiropa uye kuongororwa kwesimbi.
• Mapakeji ekuongorora hutano zvinokonzera maLFTs akawanda asina kujairika. Kusajairika kumwe chete mumunhu ane hutano kunowanzoda kuongororwa uye kudzokorora, kwete kutya.
• Dziviriro yedata: Kana ukatumira ruzivo kuburikidza nechero fomu repamhepo kana portal yekudhawunirodha mishumo, kubata data rehutano hwemunhu kunotongwa neMutemo weDhijitari weDziviriro yeData reMunhu, 2023.

Mutengo neinishuwarenzi muIndia

Panel yeLFT yakajairika ndeimwe yemhando dzekuongorora ropa dzinodhura zvishoma muIndia, kazhinji dzinodhura mazana mashoma erupi mubazi rakazvimirira, nehurumende nemasangano ehurumende vachiwanzobhadharisa mari shoma kana kusabhadhara. Mitengo inokwira zvakanyanya kana kuongororwa kwacho kuchienda kuhepatitis serology, autoimmune panels, iron necopper studies, ultrasound, elastography, CT, MRI/MRCP kana biopsy.

Zvinhu zvinokanganisa mutengo:

• Guta nedanho renzvimbo yacho; Marabhoritari ane mvumo yeNABL zvichienzaniswa neasina mvumo
• Kunyangwe LFT iri yega kana kuti chikamu chepakeji yekuongorora hutano
• Huwandu hwevanoongorora hwakabatanidzwa, mamwe mapaneru "akawedzerwa" anowedzera GGT, LDH kana PT/INR
• Mari yekutora zvinhu kumba uye kugadziriswa kwekukurumidzira kana mushure memaawa ekushanda
• Kudzokorora bvunzo nekutarisa kakawanda
• Kuongororwa kwemifananidzo kana kubvunza nyanzvi kunofanira kuwedzerwa

Maitiro einishuwarenzi: kuongororwa kwevarwere vari kunze kwechipatara uye kuongororwa kwehutano hwekudzivirira kazhinji hazvibatanidzwi muinishuwarenzi yehutano inotsiva muIndia, nepo bvunzo dzakafanana dzinoitwa panguva yekubvumidzwa kwekurapwa kana kutarisirwa kwevana dzinowanzo vharwa. Kuvharwa kunoenderana neinishuwarenzi yemunhu, nguva yekumirira uye zvikamu zvechirwere zviripo, simbisa neinishuwarenzi yako usati waongororwa. Nhamba dzese dziri pano dzinoratidza chete uye dzinochinja nenzvimbo, nzvimbo nenguva; bvunza nzvimbo kuti uwane mutengo wemazuva ano.

Ngano nezvokwadi

Mibvunzo inowanzobvunzwa

Maitiro ese eLFT anotora nguva yakareba sei?

Kutorwa kweropa pachako kunotora maminetsi mashoma, uye kushanya kunosanganisira kunyoresa nekumirira kunowanzova maminetsi gumi nemashanu kusvika makumi matatu. Nguva yekugadzirisa murabhoritari nekuburitswa kwemushumo zvinosiyana zvichienderana nenzvimbo uye zvinoenderana nekuti sampuro yacho inoitiswa nguva dzose here kana kuti nekukurumidza, saka bvunza nzvimbo yako yekutora ropa kuti ikupe purogiramu yayo.

Ndinofanira kutsanya here kuti ndiongororwe mashandiro echiropa?

Kutsanya hakudiwi pamunhu ane LFT chete. Mapakeji mazhinji ehutano hweIndia anobatanidza LFT neglucose yekutsanya kana lipids, uye kana zvakadaro kutsanya kunogona kukumbirwa. Tevedzera mirairo yakanyorwa yerabhoritari yako. Kana ukatora insulin kana sulfonylureas, bvunza chiremba wako kuti ungatora sei mishonga mangwanani ekutsanya.

SGPT yakafanana neALT here, uye SGOT yakafanana neAST here?

Ehe. SGPT neALT ienzyme imwe chete ine mazita maviri, sezvakaita SGOT neAST. Marabhoritari ekuIndia anowanzo dhinda mazita eSGPT neSGOT. ALT inonyanya kushandiswa pachiropa; AST inobvawo mutsandanyama, mwoyo nemasero matsvuku eropa, saka AST inogona kumuka pasina dambudziko rechiropa.

SGPT yangu yakakwira zvishoma asi ndiri kunzwa zvakanaka chose. Chii chinotevera?

Kukwira zvishoma kwakajairika. Matanho anotevera anowanzo sanganisira kuongororwa kwemishonga nezvinowedzera, nhoroondo yedoro, kuongororwazve mushure memavhiki mashoma uchidzivisa kurovedza muviri zvakanyanya usati waita, kuongororwa kwehepatitis B neC, kuongororwa kwemetabolism, uye fibrosis score. Chiremba wako anosarudza kutevedzana kwacho zvichienderana nezvinhu zvinokukonzera njodzi.

Ko maekisesaizi kana ma gym supplements anogona kuwedzera ma enzymes echiropa here?

Ehe. Kudzidzira muviri nesimba kunogona kuwedzera AST uye, zvishoma, ALT kubva mutsandanyama pane chiropa. Pamwe chete, mamwe ma supplements ekuvaka muviri nekuderedza uremu akakonzera kukuvara kwechiropa chaiko. Udza chiremba wako nezvezvigadzirwa zvese zvakashandiswa, zviri nani uuye nepakeji yacho, uye taura nezvemaekisesaizi akawanda achangoburwa usati waedzwa.

Kukwira kwebilirubin kunoreva jaundice here kana chirwere chechiropa?

Kwete. Kukwira zvishoma kwe bilirubin isina kubatana ine hunhu hwakajairika mumunhu akagwinya kunowanzo ratidza Gilbert syndrome, shanduko isina njodzi inogarwa nhaka iyo inova pachena zvakanyanya kana munhu achitsanya kana kurwara. Kubuda kweropa zvishoma ndeimwe tsananguro. Kutsvuka kweyero kunoonekwa kunowanzo da bilirubin yakakwira uye kunoda kuongororwa nachiremba nekukurumidza.

MaLFT asina kujairika anogona kudzokera kune zvakajairika here?

Kazhinji, hongu, kana chikonzero chinogadziriswazve chakadai semushonga, supplementary, doro kana acute viral hepatitis chikagadziriswa, uye kazhinji nekuvandudzwa kwemetabolic metabolic muMASLD. Cirrhosis yakawanikwa haidzokeri shure, kunyange hazvo kufambira mberi kwayo kuchiwanzo deredzwa. Mhedzisiro inosiyana zvichienderana nemamiriro ekurapa emunhu mumwe nemumwe.

Ultrasound iri nani pane LFT here?

Hapana ari nani pane mamwe; anopindura mibvunzo yakasiyana. LFT inoratidza kana paine kukuvara kwemakemikari kana kuvharika uye kuti maitiro acho akaita sei. Ultrasound inoratidza chimiro, mafuta, saizi, maronda, matombo emunduru, kuwedzera kwemudzira. Ultrasound haigone kuongorora kuzvimba uye inogona kupotsa steatosis isina kusimba uye matombo madiki emudzira wenduru.

Mhuri yangu inofanira kuongororwa here kana ndine hepatitis B?

Nhengo dzemhuri uye vadikani vepabonde vemunhu ane hepatitis B vanowanzo kurudzirwa kuti vaongororwe, uye kana vasina dziviriro yechirwere, vabaiwe majekiseni. Vana vacheche vevanaamai vane hepatitis B vanoda matanho chaiwo panguva yakakodzera. Kurukurai zvirongwa zvekuyedza uye zvekubaiwa majekiseni nachiremba ari kurapa.

Sources

• Rinella ME, nevamwe. Chirevo cheDelphi chemasangano akawanda pamusoro pemazita matsva echirwere chechiropa chine mafuta (2023), chinotsanangura chirwere chechiropa chinonzi steatotic, MASLD, MASH uye MetALD.
• Nhungamiro yekiriniki yeAmerican College of Gastroenterology pamusoro pekuongororwa kwemakemikari echiropa asina kujairika. [Simbisa chinyorwa chiripo, CHICHASIMBISWA]
• Nhungamiro dzekiriniki dzeEASL pamusoro pezvirwere zvechiropa zvine cholestatic uye pamusoro pekuongororwa kusingapindi muropa kwechirwere chechiropa. [Simbisa chinyorwa chiripo, CHICHASIMBISWA]
• Nhungamiro yeWorld Health Organization pamusoro pekuongororwa nekurapwa kwehepatitis B nehepatitis C. [Simbisa chinyorwa chiripo, CHICHASIMBISWA]
• Chirongwa cheNyika cheKudzora Hepatitis, Bazi reHutano neKugara Kwemhuri, Hurumende yeIndia.
• Mutemo weDhijitari weDziviriro yeRuzivo Rwemunhu, 2023; Mutemo weMishonga neMashiripiti (Zviziviso Zvinopikisa) we1954.