Uvavanyo lweSibindi oluNgaqhelekanga (LFT): Ithetha ukuthini imiphumo, izizathu kunye namanyathelo alandelayo

Ukuthatha okuphambili

• I-LFT engaqhelekanga yingcaciso, ayisiyonto yokuxilonga. Amanani afanayo anokuvela kwisibindi esinamafutha, intsholongwane, iyeza okanye unobangela ongesiso isibindi.
• Ipateni ibaluleke ngaphezu kwanoma yiliphi inani elinye. Iipateni ze-Hepatocellular (ALT/AST-dominant) kunye ne-cholestatic (ALP/GGT/bilirubin-dominant) zikhomba kwicala elahlukileyo.
• Ii-LFT eziqhelekileyo azikhuphi isifo sesibindi. I-cirrhosis kunye ne-fibrosis ebalulekileyo zinokubakho ngee-enzymes eziqhelekileyo.
• Ezinye izinto ezingaqhelekanga zingxamisekile. I-jaundice enokudideka, ukozela okanye ukopha kufuneka ihlolwe ngokukhawuleza.
• Uvavanyo oluphindaphindwayo ludla ngokuba linyathelo elilandelayo elifanelekileyo, kwaye utoliko lologqirha ocele uvavanyo. Iziphumo ziyahluka ngokuxhomekeke kwiimeko zeklinikhi zomntu ngamnye.

Ngokukrwaqula kanye

Kwaziwa njenge

• I-LFT, iphaneli yesibindi, iprofayili yesibindi, ikhemistri yesibindi, iphaneli yomsebenzi wesibindi
• Uvavanyo lwe-SGPT kunye ne-SGOT, amagama e-ALT kunye ne-AST asetyenziswa imihla ngemihla eIndiya
• "Uvavanyo lwesibindi", "uvavanyo lwegazi lesibindi", "uvavanyo lwe-jaundice" (olugxile kwi-bilirubin)
• Iilwimi zomthonyama: liver ki jaanch, uvavanyo lwe-peelia
• Qaphela: "uvavanyo lokusebenza kwesibindi" ligama lembali. Uninzi lwezinto ezisetyenziswayo zilinganisa ukwenzakala kwesibindi okanye ukuhamba kwenyongo endaweni yokusebenza ngokwenene.

Yintoni i-LFT engaqhelekanga

Iphaneli yesibindi inika ingxelo yemilinganiselo emininzi engadibaniyo. Ngayinye iziphatha ngendlela eyahlukileyo:

• I-SGPT/ALT kunye ne-SGOT/AST zi-enzymes ezikhutshwayo xa iiseli zesibindi zenzakele. I-AST ikwavela kwizihlunu, intliziyo kunye neeseli ezibomvu zegazi, ngoko ke i-AST inokunyuka ngaphandle kwesifo sesibindi.
• I-ALP Iyanda ngenxa yeengxaki zombhobho wenyongo, kodwa ikwavela emathanjeni, kwi-placenta namathumbu. Abantwana abakhulayo kunye nokukhulelwa badla ngokubonisa i-ALP ephezulu.
• I-GGT ibuthathaka kodwa ayicaci. I-GGT inyuka ngotywala, amayeza amaninzi kunye nesibindi esinamafutha, kwaye i-GGT ephakanyisiweyo yodwa ayithethi nto ingako.
• Bilirubin inyuka xa inyongo ingaphathwa kakuhle, ivaleke imibhobho yenyongo, okanye iqhekeke iiseli ezibomvu (i-haemolysis). I-Gilbert syndrome ibangela ukunyuka okungengozi okungaxinaniswanga, okuhlala kubonakala ngakumbi emva kokuzila ukutya okanye ukugula.
• I-Albumin kunye neproteni iyonke ibonisa ukwenziwa, kodwa ikwabonisa nesondlo, ukudumba, ukulahleka kweprotheyini yezintso kunye nokulahleka kwamathumbu.
• PT/INR (idla ngoku-odolwa ngokwahlukeneyo) yenye yeempawu ezimbalwa zokwenyani zomsebenzi wokwenziwa kwesibindi.

Iflegi "engaqhelekanga" kwingxelo ithetha ukuba ixabiso lingaphandle kwexesha lereferensi yelabhoratri. Izithuba zereferensi zahlukile phakathi kweelabhoratri ngokwendlela, i-analyzer kunye nenani labantu, yiyo loo nto igazi elifanayo linokubekwa uphawu kwenye ilebhu hayi kwenye. Soloko ufunda uluhlu olushicilelweyo kwingxelo yakho endaweni yokuthelekisa neyomnye umntu.

Kutheni kuphandwa nge-LFTs ezingaqhelekanga

• Ukwahlula izizathu zesibindi kwizinto ezingezizo ezesibindi ezifana nokwenzakala kwemisipha, isifo se-thyroid, isifo se-celiac, ukusilela kwentliziyo okanye i-hemolysis.
• Ukuchonga izizathu ezinokunyangwa: i-hepatitis B kunye ne-C, i-hepatitis ye-autoimmune, isifo sikaWilson, i-haemochromatosis, ukwenzakala kwesibindi okubangelwa ngamayeza, ukuvaleka kombhobho wenyongo.
• Ukufumanisa isifo sesibindi esibangelwa kukungasebenzi kakuhle kwe-metabolic (MASLD), igama langoku elithatha indawo ye-NAFLD, kunye nokukhangela i-fibrosis, nto leyo echaphazela kakhulu iziphumo zexesha elide.
• Ukugweba ubukhali xa kukho i-jaundice, i-ascites okanye ukudideka.

Ngubani ofanele ahlolwe ukusebenza kwesibindi

• Nabani na one-jaundice, umchamo omnyama, indle ekhanyayo, ukurhawuzelela okungapheliyo, iintlungu zesisu esisezantsi ngasekunene, isicaphucaphu esingachazwanga okanye ukudinwa okuphawulekayo.
• Abantu abadumba esiswini, abanezivubeko okanye abahlanza igazi ngokukhawuleza.
• Abantu abanesifo seswekile sohlobo lwesibini, abanesifo sokunganyamezelani ne-insulin, abanesifo se-dyslipidaemia, abanesifo soxinzelelo lwegazi okanye abafumana ubunzima obuphakathi, apho isifo sesibindi esibizwa ngokuba yi-steatotic liver disease sixhaphakileyo. Kuma-Asiya aseMzantsi, isifo sesibindi esibizwa ngokuba yi-metabolic liver disease senzeka kwi-body mass index ephantsi kunakwamanye amazwe amaninzi.
• Abantu abasebenzisa amayeza anokuba yingozi kwisibindi xa umcebisi ecebisa ukuba bajonge, umzekelo unyango oluchasene nesifo sephepha, i-methotrexate, amayeza athile okulwa nesifo sokuwa, amayeza okulwa nentsholongwane, kunye namanye amayeza okulwa nentsholongwane. Iishedyuli zokujonga zimiselwa ngumcebisi.
• Abantu abasebenzisa izongezo ze-AYUSH, zezityalo, ezokunciphisa umzimba okanye zejimu, ezizezona zibangela zokulimala kwesibindi ezibangelwa ngamayeza eIndiya.
• Abantu abasebenzisa utywala rhoqo okanye abasebenzisa kakhulu utywala.
• Abantu abane-hepatitis B okanye C, okanye ilungu losapho eline-hepatitis B, kunye nabo banembali yesifo sesibindi kusapho, isifo sikaWilson okanye i-haemochromatosis.
• Abantu abanesifo sesibindi esinganyangekiyo, ukuze bajongwe rhoqo.

Ukuhlolwa rhoqo kwe-LFT kumntu ongenazo iimpawu kwaye ongenazo izinto ezinobungozi kudla ngokuvelisa iziphumo ezingaqhelekanga ezikhokelela kuvavanyo olongezelelweyo ngaphandle kwenzuzo. Xoxa nogqirha ukuba ngaba uvavanyo luphendula umbuzo wokwenene kuwe.

Oko i-LFT ingenakukwazi ukukubona okanye ukungakubandakanyi

• I-LFT ayiniki ngxelo yokuxilongwa. I-SGPT ephakanyisiweyo ayichazi ukuba unobangela kukutyeba, yintsholongwane, liyeza okanye yinkqubo yokuzikhusela komzimba.
• I-LFT ayilinganisi i-fibrosis okanye i-cirrhosis. Abantu abane-cirrhosis eqinisekisiweyo bahlala benee-enzymes eziqhelekileyo okanye eziphantse zibe zezoqhelekileyo. I-LFT eqhelekileyo ayikhuseli isifo sesibindi esiqhubele phambili.
• I-LFT ayibonisi umfanekiso wesibindi okanye imibhobho yenyongo. Amatye enyongo, amatye enyongo, amaqhuqhuva, ithumba kunye namaqhuqhuva awabonakali kwiphaneli yegazi.
• I-LFT ayihloli umhlaza wesibindi. Ukubeka esweni abantu abasemngciphekweni kusebenzisa imifanekiso, nokuba ine-AFP okanye ayinayo, njengoko kucetyiswa yingcali yezifo zesibindi.
• Ukuphakama kwe-enzyme akulingana nobunzima. I-ALT ephezulu kakhulu inokwenzeka kwi-hepatitis yentsholongwane ezithintelayo; i-ALT ephantse ibe yeqhelekileyo inokuhamba ne-decompensated cirrhosis.
• I-albumin eqhelekileyo kunye ne-bilirubin aziqinisekisi ukusebenza kakuhle kwizifo zakuqala, njengoko ezi zitshintsha kade.
• I-LFT ayichongi intsholongwane ethile. IHepatitis A, B, C kunye no-E zifuna uvavanyo olwahlukileyo lwe-serological.

Isiphumo esichazwe njenge "esingachazwanga" okanye "esikufutshane" sichaza oko kwalinganiswa ngelo xesha, asisithinteli isifo. Ukuba iimpawu ziyaqhubeka nangona iziphumo ziqhelekile, buyela kugqirha wakho.

Iimviwo ezinxulumeneyo kodwa ezahlukeneyo

Ezi ziyahambelana, azibekwanga phantsi. Ukuba yeyiphi eza kuqala kuxhomekeke kwindlela ebonakala ngayo: i-jaundice engenabuhlungu kunye nokurhawuzelelwa kunye nepatheni ye-cholestatic idla ngokubangela ukuba kuthathwe imifanekiso ye-bile ducts kwangethuba; i-SGPT ephakanyisiweyo kancinci enesifo seswekile kwaye ingenazo iimpawu idla ngokubangela ukuba kuphindwe kuhlolwe, kuhlolwe amayeza kunye notywala, kuhlolwe i-hepatitis B kunye ne-C kunye namanqaku e-fibrosis ngaphambi kwayo nayiphi na enye into.

Ukulungiselela

Ukulungiselela ngumsebenzi kwaye kuyahluka ngokweelebhu. Imiyalelo ebhaliweyo yeyunithi yakho ibaluleke ngaphezu kwayo nayiphi na into apha.

• Ukuzila ukutya akusoloko kuyimfuneko kwi-LFT yodwa. Iilabhoratri ezininzi zaseIndiya zibopha i-LFT kwiphakheji yezempilo ene-lipids okanye i-glucose yokuzila ukutya, apho kunokucelwa ukuzila ukutya.
• Zisa uluhlu olupheleleyo lwamayeza, kuquka iintlungu, amayeza okubulala iintsholongwane, amayeza okulwa nesifo sephepha, kunye nazo zonke izongezo zezityalo, i-AYUSH, i-ayurvedic, i-homeopathic kunye ne-gym okanye izongezo zokunciphisa umzimba.
• Xelela ilabhoratri malunga nokusela utywala kutshanje, umthambo onzima okanye umsebenzi wejimu kutshanje, ukugula kutshanje kunye nokukhulelwa.
• Phatha iingxelo ze-LFT zangaphambili. Ithrendi ngokuhamba kwexesha idla ngokuba nengcaciso engaphezulu kunexabiso elinye.
• Musa ukuqala, ukuyeka okanye ukutshintsha naliphi na iyeza elinikwe ngugqirha ukuze "uphucule" iziphumo. Thetha nogqirha.

Ukuba uzila ukutya kwaye uthatha amayeza okwehlisa iswekile

Ukuzila ukutya ixesha elide kunokubangela i-hypoglycemia kubantu abasebenzisa i-insulin okanye i-sulfonylureas. Buza umntu okunika ulwalathiso ukuba ungayilawula njani idosi ekuseni, bhukisha ixesha lokuphumla kwangethuba, kwaye uphathe umthombo weswekile.

Ukukhulelwa

I-ALP iyanda ngokuqhelekileyo xa ukhulelwe ngenxa yokuveliswa kwe-placenta, ngoko ke i-ALP ephezulu ayisoloko iyingxaki yesibindi. Nangona kunjalo, ukurhawuzelelwa ekukhulelweni kamva kufuna uvavanyo olukhawulezileyo lwe-cholestasis yokukhulelwa ngaphakathi kwesibindi. Xela ukurhawuzelelwa okutsha, i-jaundice, iintlungu eziqatha zesisu esingaphezulu, intloko ebuhlungu okanye ukuphazamiseka kokubona kugqirha wakho wotyando ngokukhawuleza.

abantwana

I-ALP idla ngokuba phezulu kakhulu kubantwana abasakhulayo nakubantu abakwishumi elivisayo, kwaye amaxesha okubhekisela kubantwana ayahluka ngokweminyaka. Iziphumo zabantwana kufuneka zitolikwe ngokweminyaka ethile ngugqirha wabantwana.

Abantu abadala, i-CKD kunye nokusilela kwentliziyo

I-Albumin iyehla ngokukhula, ukudumba okungapheliyo, ukulahleka kweprotheyini yezintso kunye nokungatyi kakuhle. Kwisifo sentliziyo, ukuxinana kwesibindi kunokunyusa ii-enzymes kunye ne-bilirubin ngaphandle kwesifo sesibindi esiyintloko. Ukuba unemida yolwelo, musa ukwandisa ulwelo ngaphambi kovavanyo lwegazi ngokwengcebiso eqhelekileyo.

Kwenzeka ntoni ngexesha lovavanyo

Ingcali ye-phlebotomist ihlambulula ulusu, ifake i-tourniquet ize itsale igazi, ngokuqhelekileyo emthanjeni osengalweni. Ukutsalwa kuthatha imizuzu embalwa. Intlungu encinci, ukudumba okufutshane okanye i-hematoma encinci inokwenzeka; ukuquleka akuvamile kodwa kunokwenzeka, ngoko ke khankanya ukuba ukhe waquleka xa kuvavanyo lwegazi ngaphambili. Uxinzelelo kwindawo leyo umzuzu okanye emibini lunciphisa ukudumba. Uninzi lwabantu luqala kwakhona imisebenzi eqhelekileyo ngoko nangoko. Abantu abasebenzisa amayeza okunciphisa igazi kufuneka babambe uxinzelelo ixesha elide kwaye baxelele ingcali ye-phlebotomist ngeyeza.

Ukuqonda ingxelo yakho

Funda uluhlu lweereferensi zengxelo yakho. Amanani awafaniswa kuzo zonke iilabhoratri. Imibuzo eluncedo yile: leliphi iqela lexabiso eliphakanyisiweyo, lingakanani, kwaye liyatshintsha?

Ipateni ye-hepatocellular

I-SGPT/ALT kunye ne-SGOT/AST ziphakanyiswa ngaphandle kwe-ALP. Unxulumano oluqhelekileyo lubandakanya isifo sesibindi esibizwa ngokuba yi-steatotic, utywala, amayeza kunye nezongezo, i-viral hepatitis (kuquka i-hepatitis E, exhaphakileyo eIndiya), i-autoimmune hepatitis, isifo se-coeliac, iingxaki ze-thyroid kunye nesifo sikaWilson kwizigulane ezincinci.

Ipateni yeCholestatic

I-ALP kunye ne-GGT ziphakanyiswa ngendlela engalinganiyo ne-transaminases, zihlala zine-bilirubin ephezulu, umchamo omnyama, isitulo esikhanyayo kunye nokurhawuzelelwa. Izizathu ziquka amatye e-bile duct, izithintelo, iithumba ezicinezela i-duct, i-cholestasis ebangelwa ngamayeza kunye ne-primary biliary cholangitis. Le ndlela idla ngokukhokelela ekuthathweni kwemifanekiso yomthi we-bile tree.

I-bilirubin ephakanyisiweyo ehlukanisiweyo

Ukuba i-bilirubin inyuswe kancinci, uninzi lwayo aludibananga, kwaye zonke ezinye izinto ziqhelekile kumntu ophilileyo, i-Gilbert syndrome okanye i-mild hemolysis zizizathu eziqhelekileyo. I-Haemolysis ihlolwa ngovavanyo olongezelelweyo olufana ne-reticulocyte count kunye ne-LDH.

I-ALP okanye i-GGT ephakanyisiweyo ehlukanisiweyo

Ukunyuka kwe-ALP kukodwa kunokuba yimvelaphi yethambo okanye ye-placenta. Ukunyuka kwe-GGT kukodwa akucaci kwaye akudingi manyathelo ngaphandle kokujonga utywala namayeza, kunye nokuvavanywa kwakhona.

I-albumin ephantsi

I-albumin ephantsi inokubonisa isifo sesibindi esingapheliyo kodwa ikwabonisa nesifo esiqatha, usulelo, isifo se-nephrotic, isifo samathumbu esilahlekelwa yiproteni okanye ukungondleki kakuhle. Ukutolikwa kufuna umfanekiso weklinikhi.

Akukho nani apha elifanele lifundwe njengoxilongo. Ingcaciso yeyogqirha oye wayalela uvavanyo, ngokwembali yakho, amayeza kunye novavanyo.

Xa iziphumo ze-LFT zinokulahlekisa

Ukuphakama okungeyonyani okanye okungekho kwisibindi

• AST: Ukuzilolonga okunzima, uqeqesho lobunzima bejimu, inaliti zemisipha, isifo semisipha, i-haemolysis kwisampuli, kunye nokwenzakala kwemisipha yentliziyo okanye yamathambo kunokunyusa i-AST xa isibindi siphilile.
• I-ALP: ukukhulelwa (i-placental), ukukhula kobuntwana nokufikisa, ukuphiliswa kwamathambo aqhekekileyo kunye nesifo samathambo.
• IBilirubin: ukuzila ukutya ixesha elide okanye ukugula okukhawulezileyo kwi-Gilbert syndrome; i-haemolysis kwityhubhu yesampuli; amayeza athile aphazamisana nokuphathwa kwe-bilirubin.
• GGT: utywala bamva nje, amayeza aliqela aqhelekileyo, ukutyeba kakhulu, amaxesha amaninzi ngaphandle kwesifo sesibindi esibalulekileyo ngokwezonyango.
• Ukuhanjiswa okulibazisekileyo okanye isampuli efakwe igazi elimdaka inokunyusa i-AST, i-bilirubin kunye ne-potassium ngendlela engeyiyo; ukuphinda iisampulu kusombulula amathandabuzo.

Ukuqinisekisa ngobuxoki okanye ukuthotywa ngobuxoki

• Iienzymes eziqhelekileyo kwisifo esiphambili: kwi-cirrhosis, amanqanaba ee-enzyme adla ngokuhla aye kwisiqhelo njengoko ukusebenza kwezicubu zesibindi kulahleka.
• I-ALT eqhelekileyo kwi-MASLD ebalulekileyo ene-fibrosis ixhaphakile, ngoko ke i-LFT eqhelekileyo ayisiyonto yokucoca.
• I-AST/ALT yehliswa kukungabikho kwe-vitamin B6 ichazwe, kwaye inganciphisa ukunyuka kwee-enzyme okulindelekileyo.
• Uvavanyo lwenqaku elinye: Amanqanaba eeenzyme ayatshintshatshintsha kwi-hepatitis C engapheliyo kunye ne-hepatitis ye-autoimmune, ngoko ke ukufundwa okuqhelekileyo ngosuku olunye kunokungaphumeleli.
• I-Bilirubin ingaba yinto eqhelekileyo ekuvalekeni kwe-bile duct kwangethuba nakwizifo ezininzi zesibindi ezingapheliyo.

Iingozi kunye nokhuseleko

Uvavanyo lwegazi

Ukubhoboza igazi emzimbeni kuneengozi ezincinci: iintlungu, ukukrweleka, i-hematoma, ukuba nentloko ekhaphukhaphu, kunye nosulelo olungaqhelekanga okanye ukurhawuzelelwa yimithambo-luvo. Ezi zihlala zincinci kwaye zihlala ixesha elifutshane. Abantu abasebenzisa amayeza okunciphisa ukugabha kwegazi okanye abaneengxaki zokopha kufuneka baxelele abasebenzi kwangaphambili.

Imifanekiso esezantsi

I-Ultrasound ayisebenzisi i-ionizing radiation. I-CT ibandakanya ukuvezwa kwimitha kwaye i-iodine contrast isenokungafanelekanga kwabanye abantu abanengxaki yezintso okanye ii-contrast reactions zangaphambili. I-MRI ifuna uvavanyo lokhuseleko lwe-implants, i-pacemakers kunye neziqwenga zesinyithi. Ngayinye kwezi ineprofayili eyahlukileyo yomngcipheko kwaye igqitywa ngokwemeko nganye.

I-biopsy yesibindi

I-Biopsy yinkqubo yokungenelela enemingcipheko equka iintlungu, ukopha igazi, kwaye, ngokungafane kwenzeke, ukwenzakala kwizakhiwo ezikufutshane. Igcinelwe iimeko apho ukuxilongwa kwezicubu kutshintsha ulawulo, kwaye imvume ibandakanya ingxoxo ngezi ngozi. Iziphumo ziyahluka ngokuxhomekeke kwiimeko zeklinikhi nganye.

Izizathu ze-LFTs ezingaqhelekanga

• Isifo sesibindi esibizwa ngokuba yi-Steatotic Liver Disease (SLD): igama elibalulekileyo elaqaliswa kwisivumelwano seDelphi semibutho emininzi ngo-2023 (uRinella et al.). I-MASLD ithatha indawo ye-NAFLD; i-MASH ithatha indawo ye-NASH; i-MetALD ichaza isifo sesibindi se-steatotic esingasebenzi kakuhle emzimbeni esinegalelo elikhulu kutywala. Isifo sesibindi esinxulumene notywala ludidi olwahlukileyo.
• I-Hepatitis yentsholongwane: i-hepatitis A kunye ne-E (edla ngokuba yi-acute, efumaneka emanzini nasekutyeni, exhaphakileyo eIndiya), i-hepatitis B kunye ne-C (inokuba yi-chronic kwaye ingathethi), i-hepatitis D kwabo bane-hepatitis B.
• Isifo sesibindi esinxulumene notywala, ukususela kwisibindi esinamafutha ukuya kwi-hepatitis ebangelwa butywala ukuya kwi-cirrhosis.
• Ukulimala kwesibindi okubangelwa ngamayeza kunye nezongezo: i-paracetamol ekusetyenzisweni ngokugqithisileyo, amayeza okulwa nesifo sephepha, amanye amayeza okubulala iintsholongwane, amayeza okuxhuzula, i-methotrexate, kunye nezongezo zezityalo, i-ayurvedic kunye nokwakha umzimba.
• Ukuvaleka kwenyongo: amatye enyongo kwi-bile duct, ii-strictures, ii-pancreatic okanye ii-biliary tumors.
• Iimeko ze-autoimmune: i-hepatitis ye-autoimmune, i-biliary cholangitis ephambili, i-primary sclerosing cholangitis.
• Iimeko ezizuzwe njengelifa: Isifo sikaWilson, i-hemochromatosis yelifa, ukungabikho kwe-alpha-1 antitrypsin, i-Gilbert syndrome (engenobungozi).
• Izizathu ezingezizo esibindini: ukwenzakala kwemisipha okanye i-myositis, isifo se-celiac, isifo se-thyroid, ukusilela kwentliziyo kunye nokuxinana kwesibindi, i-sepsis, i-haemolysis, usulelo lwe-Epstein-Barr virus.
• Iithumba zesibindi kunye ne-metastases, kunye nethumba lesibindi.

Indlela ii-LFTs ezingaqhelekanga ezivavanywa kwaye ziphathwa ngayo

Ulawulo lujolise kwisizathu, hayi kwinani. Indlela eqhelekileyo ibandakanya imbali ecokisekileyo yotywala, amayeza kunye nezongezo; uvavanyo; ukuphinda i-LFT ukuqinisekisa; uvavanyo lwe-hepatitis B kunye ne-C; uvavanyo lwe-metabolic oluquka i-glucose, i-HbA1c kunye ne-lipids; uvavanyo lwe-thyroid kunye ne-coeliac apho kufanelekileyo; isisu se-USG; kunye novavanyo lwe-fibrosis olunenqaku elifana ne-FIB-4 elilandelwa yi-elastography apho kubonisiwe khona. Ii-antibodies ze-Autoimmune, izifundo zesinyithi, izifundo ze-copper kunye ne-caeruloplasmin zongezwa xa ipateni izibonisa. I-Biopsy isetyenziswa ngokukhetha.

Unyango lulandela ukuxilongwa: unyango lwe-antiviral lwe-hepatitis B okanye C engapheliyo, ukunyanzeliswa kwamasosha omzimba kwi-hepatitis ye-autoimmune, i-chelation yesifo sikaWilson, i-venesection ye-hemochromatosis, ukuphuma kwamanzi esiswini okanye utyando lokuvaleka, ukurhoxiswa kweziyobisi okanye isongezelelo phantsi kwesikhokelo sezonyango, ukuyeka utywala ngenkxaso ecwangcisiweyo apho utywala bunegalelo khona, kunye ne-MASLD indibaniselwano yotshintsho oluqhubekayo lwendlela yokuphila, unyango lwesifo seswekile kunye ne-lipids, kunye nonyango olutsha lweziyobisi olulawulwa sisibindi kwizigulana ezikhethiweyo eziphantsi kokhathalelo olukhethekileyo. I-cirrhosis eqhubele phambili kunye nokusilela kwesibindi kunokukhokelela kuvavanyo lokufakelwa. Iziphumo zahlukile kakhulu phakathi kwabantu kunye nezizathu.

Ukunciphisa ukwenzakala kwesibindi okunokuphepheka

• Ukugonyelwa i-hepatitis B, kunye ne-hepatitis A apho kucetyiswa khona.
• Amanzi okusela akhuselekileyo kunye nococeko lokutya kunciphisa ukuvezwa kwe-hepatitis A kunye ne-E.
• Buza ugqirha okanye ingcali yezonyango ngaphambi kokuba uqale nayiphi na isongezelelo, imveliso yezityalo okanye amayeza okuphelisa iintlungu athengiswa ngaphandle kwemvume kagqirha, ingakumbi ukuba unesifo sesibindi.
• Gcina ngaphakathi kwedosi yeparacetamol ugqirha wakho akucebisayo, kwaye qaphela ukuba amayeza adibeneyo omkhuhlane akwanayo neparacetamol.
• Ukwenza umthambo rhoqo, unyango lwesifo seswekile kunye ne-lipids, kunye nokunciphisa utywala konke oku kunciphisa umngcipheko wokukhula kwesifo sesibindi esibizwa ngokuba yi-steatotic.
• Yiya ekujonganeni novavanyo lwegazi olucetyiswayo ngexesha lonyango oluchasene nesifo sephepha okanye olunye unyango olunetyhefu kwisibindi.

Ii-LFT ezingaqhelekanga kumxholo waseIndiya

• Isigama: Iingxelo zaseIndiya zihlala zibhala ii-transaminases njenge-SGPT kunye ne-SGOT endaweni ye-ALT kunye ne-AST. Zombini zibiza ii-enzymes ezifanayo. I-imaging idla ngokubhalwa njenge-"USG abdominal" okanye "sonography".
• IHepatitis E kunye ne-A Zihlala zingunobangela we-jaundice ebukhali eIndiya kwaye zihlala zizithintela, nangona i-hepatitis E ngexesha lokukhulelwa inokuba nzima kwaye ifuna unyango olukhawulezileyo nolukhawulezileyo.
• Unyango oluchasene nesifo sephepha isetyenziswa kakhulu, kwaye ukwenzakala kwesibindi okubangelwa ngamayeza ngexesha lonyango yingxaki eyaziwayo. Ungaze uyeke i-ATT ngokwakho, qhagamshelana nogqirha ngokukhawuleza ukuba kuvela i-jaundice, ukuhlanza okanye umchamo omnyama.
• Izongezo zemifuno, ze-ayurvedic kunye nezejimu zizinto eziqhelekileyo nezingaqhelekanga ezibangela ukwenzakala kwesibindi. Zisa ipakethi yokwenyani kwi-aphoyintimenti yakho.
• Isifo sesibindi esibangelwa kukusetyenziswa kwe-metabolism kwi-BMI ephantsi: Abantu baseMzantsi Asia bakhula ukumelana ne-insulin kunye namafutha esibindi kwi-body mass index ephantsi kunye nomda wesinqe, ngoko ke umntu ongabonakali etyebile kakhulu usenokuba ne-MASLD ebalulekileyo.
• Uphawu lweThalassemia kunye ne-anemia yokunqongophala kwesinyithi zixhaphakile; i-haemolysis kunye nokufakwa kwesinyithi okunxulumene notofelo-gazi kunokuchaphazela uvavanyo lwesibindi kunye nezifundo zesinyithi.
• Iiphakheji zokujonga impilo ivelisa ii-LFT ezininzi ezingaqhelekanga kancinci. Ingxaki enye encinci kumntu ophilileyo idla ngokufuna ukuphononongwa kwakhona kwaye iphindwe, kungekhona ixhala.
• Ukukhusela idatha: Ukuba ungenisa iinkcukacha ngayo nayiphi na ifomu ekwi-intanethi okanye i-portal yokukhuphela ingxelo, ukuphathwa kwedatha yezempilo yomntu kulawulwa nguMthetho woKhuseleko lweDatha yoBuqu yeDijithali, ka-2023.

Ixabiso kunye ne-inshurensi eIndiya

Iphaneli ye-LFT eqhelekileyo yenye yeendlela zovavanyo lwegazi ezingabizi kakhulu eIndiya, idla ngokuba ngama-rupee angamakhulu ambalwa kwicandelo labucala, apho amaziko karhulumente nakarhulumente adla ngokuhlawulisa imali encinci okanye angahlawuli nto. Iindleko zinyuka kakhulu xa uvavanyo lufikelela kwi-hepatitis serology, iiphaneli ze-autoimmune, izifundo zentsimbi kunye nekopolo, i-ultrasound, i-elastography, i-CT, i-MRI/MRCP okanye i-biopsy.

Izinto ezichaphazela iindleko:

• Isixeko kunye nenqanaba lesakhiwo; Iilabhoratri ezivunyiweyo yi-NABL xa kuthelekiswa neelebhu ezingavunywanga
• Nokuba i-LFT izimele okanye iyinxalenye yephakheji yokujonga impilo
• Inani labahlalutyi libandakanyiwe, ezinye iiphaneli "ezandisiweyo" zongeza i-GGT, i-LDH okanye i-PT/INR
• Iindleko zokuqokelela indlu kunye nokulungiswa ngokukhawuleza okanye emva kweeyure zomsebenzi
• Uvavanyo oluphindaphindwayo kunye nokujonga rhoqo
• Nokuba kukho ukubonisana ngemifanekiso okanye ngeengcali eziqeqeshiweyo

Indlela yokuziphatha kwi-inshurensi: ukuxilongwa kwezigulane ezingalaliswanga kunye nokuhlolwa kwempilo yokuthintela zihlala zingabandakanywa kwi-inshurensi yezempilo eqhelekileyo eIndiya, ngelixa uvavanyo olufanayo olwenziwe ngexesha lokwamkelwa okanye inkqubo yokhathalelo lwasemini evunyiweyo luhlala lugutyungelwe. Ukhuseleko luxhomekeke kwipolisi yomntu ngamnye, amaxesha okulinda kunye nezigaba zesifo esele zikhona, qinisekisa nomshwalense wakho ngaphambi kovavanyo. Onke amanani apha abonisa kuphela kwaye ayatshintsha ngokwendawo, indawo kunye nexesha; cela isaphulelo sangoku kwiziko.

Iintsomi nezibakala

Imibuzo ebuzwa qho

Ithatha ixesha elingakanani yonke inkqubo ye-LFT?

Ukutsalwa kwegazi ngokwako kuthatha imizuzu embalwa, kwaye utyelelo oluquka ubhaliso kunye nokulinda ludla ngokuba yimizuzu eli-15-30. Ixesha lokucubungula elebhu kunye nokukhululwa kwengxelo kuyahluka phakathi kwezibonelelo kwaye kuxhomekeke ekubeni isampuli iqhutywa rhoqo okanye ngokungxamisekileyo, ngoko cela iziko lakho lokuqokelela igazi ukuba likunike ishedyuli yalo.

Ngaba kufuneka ndizile ukutya ukuze ndivavanye ukusebenza kwesibindi?

Akufuneki ukuzila ukutya rhoqo kwi-LFT yodwa. Iiphakheji ezininzi zempilo zaseIndiya zidibanisa i-LFT kunye ne-glucose okanye ii-lipids zokuzila ukutya, apho ukuzila ukutya kunokucelwa. Landela imiyalelo ebhaliweyo yelebhu yakho. Ukuba uthatha i-insulin okanye i-sulfonylureas, buza ugqirha wakho ukuba ungawalawula njani amayeza ekuseni.

Ingaba i-SGPT iyafana ne-ALT, kwaye i-SGOT iyafana ne-AST?

Ewe. I-SGPT kunye ne-ALT zii-enzyme ezifanayo phantsi kwamagama amabini, njengoko kunjalo nge-SGOT kunye ne-AST. Iilabhoratri zaseIndiya zihlala ziprinta iilebheli ze-SGPT kunye ne-SGOT. I-ALT ixhomekeke ngakumbi kwisibindi; i-AST ikwavela kwizihlunu, intliziyo kunye neeseli ezibomvu zegazi, ngoko ke i-AST inokunyuka ngaphandle kwengxaki yesibindi.

I-SGPT yam iphezulu kancinci kodwa ndiziva ndiphilile ngokupheleleyo. Kuza kwenzeka ntoni emva koko?

Ukuphakama okuncinci okuzimeleyo kuqhelekile. Amanyathelo alandelayo aqhelekileyo kukuphononongwa kwamayeza kunye nezongezo, imbali yotywala, uvavanyo oluphindaphindwayo emva kweeveki ezimbalwa uphepha ukuzilolonga kakhulu ngaphambi kwexesha, uvavanyo lwe-hepatitis B kunye ne-C, uvavanyo lwe-metabolism, kunye namanqaku e-fibrosis. Ugqirha wakho ugqiba ulandelelwano ngokusekelwe kwimiba yakho yomngcipheko.

Ngaba izongezo zokuzilolonga okanye zejimu ziyazinyusa ii-enzymes zesibindi?

Ewe. Uqeqesho lokumelana olunzima lunokunyusa i-AST, kwaye, kancinci, i-ALT evela kwizihlunu kunokuba ivele esibindini. Ngokwahlukileyo, izongezo ezininzi zokwakha umzimba kunye nokunciphisa umzimba ziye zabangela ukwenzakala kwesibindi ngokwenene. Xelela ugqirha wakho ngazo zonke iimveliso ezisetyenzisiweyo, kungcono ukuba uzise ipakethe, kwaye ukhankanye ukuzilolonga okunzima kwakutshanje ngaphambi kovavanyo.

Ngaba i-bilirubin ephakamileyo isoloko ithetha isifo se-jaundice okanye isifo sesibindi?

Hayi. I-bilirubin engadibaniyo ephakanyisiwe kancinci enexabiso eliqhelekileyo kumntu ophilileyo idla ngokubonisa i-Gilbert syndrome, utshintsho olungenabungozi oluzuzwa njengelifa olubonakala ngakumbi xa uzila ukutya okanye ugula. I-hemolysis encinci yenye ingcaciso. Ukutyheli okubonakalayo kudla ngokufuna amanqanaba aphezulu e-bilirubin kwaye kufuna ukuphononongwa ngokukhawuleza ngugqirha.

Ngaba ii-LFTs ezingaqhelekanga zingabuyela kwisiqhelo?

Ewe, rhoqo, xa kujongwa isizathu esinokuthi siguqulwe njengeyeza, isongezelelo, utywala okanye i-hepatitis ebangelwa yintsholongwane ebukhali, kwaye rhoqo kuphuculwe i-metabolic kwi-MASLD. I-cirrhosis eqinisekisiweyo ayijiki, nangona ukuqhubela phambili kunokucothiswa. Iziphumo ziyahluka ngokuxhomekeke kwiimeko zeklinikhi nganye.

Ngaba i-ultrasound ingcono kune-LFT?

Akukho nanye kwezi zibalaseleyo; ziphendula imibuzo eyahlukileyo. I-LFT ibonisa ukuba kukho ukwenzakala okanye ukuvaleka kwe-biochemical kwaye ikwiyiphi ipatheni. I-Ultrasound ibonisa ulwakhiwo, amafutha, ubungakanani, ukudumba, amatye enyongo, ukwanda kwe-duct. I-Ultrasound ayinakuvavanya ukudumba kwaye inokuphoswa yi-steatosis encinci kunye namatye e-bile duct amancinci.

Ngaba intsapho yam kufuneka ihlolwe ukuba ndine-hepatitis B?

Amalungu osapho kunye namaqabane esondo omntu one-hepatitis B adla ngokucetyiswa ukuba avavanywe, kwaye ukuba akanayo intsholongwane yokuzikhusela, agonywe. Iintsana ezisandul’ ukuzalwa zoomama abane-hepatitis B zifuna amanyathelo athile ngexesha elifanelekileyo. Xoxa ngezicwangciso zovavanyo kunye nokugonywa nogqirha onyangayo.

imithombo

• URinella ME, et al. Ingxelo yesivumelwano seMulti-society Delphi malunga nomenclature entsha yesifo sesibindi esinamafutha (2023), ichaza isifo sesibindi esinamafutha, iMASLD, iMASH kunye neMetalALD.
• Isikhokelo seklinikhi seKholeji yaseMelika yeGastroenterology malunga novavanyo lweekhemikhali zesibindi ezingaqhelekanga. [Qinisekisa uhlelo lwangoku, LUZA KUQINISEKISWA]
• Izikhokelo zonyango ze-EASL kwizifo zesibindi ezine-cholestatic kunye novavanyo olungangenisi umngcipheko wesifo sesibindi. [Qinisekisa uhlelo lwangoku, LUZA KUQINISEKISWA]
• Isikhokelo se-World Health Organisation malunga novavanyo kunye nonyango lwe-hepatitis B kunye ne-hepatitis C. [Qinisekisa uhlelo lwangoku, LUZA KUQINISEKISWA]
• Inkqubo yeSizwe yoLawulo lweHepatitis yeNtsholongwane, uMphathiswa wezeMpilo kunye neNtlalontle yoSapho, uRhulumente waseIndiya.
• UMthetho woKhuseleko lweDatha yoBuqu yeDijithali, ka-2023; UMthetho weZiyobisi kunye neeNgcebiso zoBugcisa (iiNtengiso ezingachasekiyo), ka-1954.