The liver performs important functions necessary to maintain the health of the body. Diseases of the gland are not always manifested by pain in the area of the organ. The manifestation of symptoms in the form of pain in the right hypochondrium, stool disorders indicate serious liver problems. To detect a pathological process in the early stages allows a preventive examination of the organ. Assays for checking the liver are the main diagnostic method. Which ones to take, the doctor determines after examining and collecting an anamnesis.
Liver function
In the human body, there are several glands that perform secretory, barrier and other functions. The liver is the largest secretory organ. Due to the close connection of the liver with other organs and blood, iron performs several important functions:
- homeostatic - participates in lymph formation, removes and neutralizes infectious agents, removes toxins; regulates blood coagulation;
- excretory - removes more than 40 compounds with bile (cholesterol, phospholipids, bilirubin, urea, alcohols and others);
- protective - neutralizes foreign, toxic compounds that come from food and form in the intestine;
- depositing - hepatocytes accumulate macroergic compounds (anhydrides, guanidine phosphates, enolphosphates) and simpler, but no less important substances (carbohydrates, fats);
- metabolic - in the nuclei of the liver parenchyma there is a synthesis of nuclear proteins, RNA transcription.
Violations of the liver leads to a sharp deterioration in the functions of the whole organism. Identifying and applying timely therapeutic measures will help keep the gland healthy. Therefore, everyone should have at least a general idea of what tests need to be taken to check the liver. Knowing the types of examination, the patient will be able to properly prepare, which will ensure the reliability of the results.
When should the liver be checked?
Iron "works" constantly. Poor quality products, poor ecology, stress give the body an additional burden. Checking the liver must be done annually.
When recognizing pathologies of the gland, an anamnesis is important. Typical symptoms of impaired liver function are:
- a feeling of pressure, heaviness in the right hypochondrium;
- recurrent epigastric pain;
- bitterness in the mouth, especially in the mornings and a long break between meals;
- decreased appetite, intolerance to products with a pungent odor, up to the feeling of nausea;
- violation of the stool, a change in its color to light;
- bloating, a feeling of fullness;
- dry skin, an unpleasant sensation of irritation, peeling;
- general weakness, fatigue;
- in women there is a violation of the menstrual cycle.
The doctor finds out if the patient has an alcohol dependence, diseases in which they take medications that negatively affect the liver. Often problems with the body are detected by chance during medical examinations. The doctor draws attention to the fact that an adult has increased bilirubin - this means that the excretory function of the gland is impaired. The hepatologist prescribes additional tests to help identify the cause of the organ's dysfunction.
What tests should be taken to check the liver
The study of the gland includes a set of diagnostic methods. They are divided into general and specific, the latter are prescribed to confirm the preliminary diagnosis made on the basis of patient complaints and test results that determine the general condition.
General analyzes:
- Clinical blood test. With liver damage, a reduced hemoglobin content is observed, white blood cells exceed 4-9 * 10⁹ / l. The presence of an inflammatory process is indicated by an increased ESR. Liver problems indicate liver problems.
- General study of urine. After submitting the biomaterial to the study, patients are interested in a doctor whether a urinalysis will show liver problems. Gland health disorders are reflected in all body fluids. A violation of the excretory function of hepatocytes is indicated by a high urinary content of bilirubin and urobilin.
Specific:
- Analysis for biochemistry. The study is comprehensive. The biomaterial for the test is venous blood. Studies of the liver are carried out using enzyme tests, PCR analysis, Quick-Pytel tests, sulene and coagulation tests.
- Hepatic tests are liver enzymes examined using biochemical analysis.
- Hepatitis tests. Tests for hepatitis antibodies are an indicator of past hepatitis and an immune response against hepatitis viruses. Samples for hepatitis B and C are among the mandatory tests. Testing is carried out during medical examinations for work, in educational institutions, upon admission of the patient to the hospital. Markers of hepatitis B and C are used to detect the presence of the virus in the body.
- Coagulogram is a test that detects hemostasis disorders. The analysis is carried out with suspected or diagnosed liver pathologies.
- Fibrotest - a study that identifies the presence and degree of fibrotic changes in the organ.
Specific tests have important diagnostic value, we will consider them in more detail.
What does a blood test for biochemistry show
Methods of studying the components of biological fluids, the processes of conversion of substances and energy are of great value in the diagnosis. They allow you to evaluate the work of internal organs and systems. Inorganic and organic substances, proteins, nucleic acids are examined.
In some laboratories, there are complexes of tests for biochemistry to check the liver. They include all the indicators by which the doctor evaluates the work of the body. In outpatient conditions, the doctor prescribes each component of the blood separately:
- Prothrombin - a coagulation test used to diagnose pathologies associated with a deficiency of coagulation factors, thrombosis. With cirrhosis, prothrombin levels are significantly reduced.
- Alpha-Amylase is a calcium-dependent enzyme synthesized by the salivary and pancreas. The norm of indicators is 25-125 units / liter.
- Cholinesterase - an enzyme belonging to the group of hydrolases, necessary for the breakdown of choline esters, synthesized in the liver. The main function of the enzyme is the processing of toxic substances. Exceeding the content of 5300-12900 units / l speak of violations of the liver.
- Total protein is the total concentration of albumin and globulin in the blood. The indicator is necessary for the diagnosis of liver pathologies, metabolic disorders. The norm of the protein content in the blood is 65-85 g / l. A decrease in the level can be caused by liver failure due to toxic lesions of the gland, hepatitis, cirrhosis.
- Direct bilirubin is a water-soluble bile pigment excreted in the bile. In a healthy person, the indicators do not exceed 3.4 μmol / L. The main cause of hyperbilirubinemia is damage to the hepatocytes. Direct bilirubin increases with parenchymal jaundice, alcoholic and viral hepatitis.
Liver tests
An analysis of biochemical enzymes that helps assess the degree of liver damage is called liver function tests. It is prescribed both to patients with signs of pathology of the gland, and without characteristic symptoms.
Liver enzymes are evaluated by a biochemical blood test. According to the test results, the ability of the gland to absorb toxic substances, remove them from the blood, metabolic function is studied.
Hepatic indicators:
- Albumin is a protein fraction synthesized by the liver. Normally, the content of the substance in the blood serum is 55.2-64.2%. Reduced indicators indicate diffuse lesions (changes in size and structure) up to dystrophy and necrotization. An enzyme content below 40% is an indicator of chronic liver failure.
- Alanine aminotransferase (AlAT) and aspartate aminotransferase (AsAT) are enzymes that transfer alanine to alpha-ketoglutaric acid. Enzymes are synthesized intracellularly, only a small part of them enters the bloodstream. With liver damage, the concentration of AlAT and AsAT in serum exceeds the limits of 0.9–1.75.
- Common bilirubin is a bile pigment formed during the breakdown of hemoglobin, hemoproteins, myoglobin. In case of impaired liver function, pigment absorption and impairment of its release to the intrahepatic bile ducts are reduced. Increased bilirubin, what does this mean in an adult? A large concentration of yellow pigment may indicate hepatitis, abscess, cirrhosis. A low level may be the result of taking antibiotics, salicylates, corticosteroids.
- GGT (Gamma-glutamyltransferase) is a liver protein whose activity in blood serum increases with alcohol abuse and gland pathologies.
- Alkaline phosphatase (ALP) is an enzyme with the help of which dephosphorylation of alkaloids and nucleotides occurs. Normally, the content of alkaline phosphatase is 30-130 units / liter. Excess concentration can be caused by cirrhosis, liver tuberculosis.
Not a single indicator is given individually about the presence of a pathology, its severity is judged only by the results of a comprehensive examination.
Coagulogram
Tests to check the liver in addition to biochemistry include indicators of hemostasis. The gland performs a homeostatic function, blood coagulation disorders can be caused by damage to hepatocytes, the formation of scar glands in the parenchyma.
Coagulogram (hemostasiogram) - a study of the coagulation and anticoagulation ability of blood. The analysis reveals chronic liver diseases. The coagulogram includes the study of several indicators. The following are of value for the diagnosis and monitoring of gland pathologies:
- Prothrombin time and INR - indicators of the external pathway of blood coagulation. INR - ratio of patient's PV to standard PV. Normal values of PV - 11-15 seconds. An increase in indicators may be associated with cirrhosis, hepatitis.
- Thrombin time is a test during which the speed with which a fibrin clot forms after the introduction of thrombin into the blood is determined. Normal values vary between 14-21 seconds.
- Fibrinogen is a protein that is the basis of a clot during blood coagulation, produced in the liver. A decrease in the level of reference values (1.9-3.5 g / l) may indicate inflammation of the liver tissue, the degeneration of the parenchyma into fibrous tissue.
- Antithrombin III is a protein that prevents excessive blood clot formation. Glycoprotein is produced in hepatocytes and in a single layer layer of blood vessels and is an endogenous coagulant. In adults, the normal level of antithrombin III is 66-124%. One of the reasons for the increase in glycoprotein is acute cholestasis and hepatitis. The low content of the enzyme also indicates cirrhosis of the liver, liver failure.
- D-dimer is a protein that reflects the activity of thrombosis and fibrinolysis. The level of D-dimer in a healthy person does not exceed 0.55 μg FEU / ml. One of the factors influencing the increase in the rate are liver diseases.
To assess the condition of the gland, they look, which shows a blood test for biochemistry and a coagulogram. Only on the basis of the results of a comprehensive examination, the doctor can make a diagnosis.
Markers of viral hepatitis
If in the analysis for biochemistry there is a significant excess of bilirubin, alanine aminotransferase, aspartate aminotransferase, albumin, the doctor prescribes additional studies for hepatitis.
Botkin's disease is detected by an enzyme-linked immunosorbent assay using an anti-HAVIgM marker. Antibodies are produced from the first days of infection.
The following markers are used to determine hepatitis B:
- Anti HBsAg - antibodies to hepatitis B surface antigen, an indicator of a previous disease;
- HBeAg - marker reveals the active stage of the disease;
- Anti-HBc - detects the presence of antibodies, but does not provide information on the degree of progression of the pathology;
- Ig Anti-HBc - indicates active reproduction of the infectious agent;
- Anti-HBe - detected during recovery.
Markers for determining hepatitis C:
- Anti-HCV - total immunoglobulins M and G. Antibodies are determined at 4-6 weeks after the infectious agent enters the body;
- Anti-HCV NS is found in acute and chronic forms of pathology.
- HCV-RNA indicates virus activity.
If markers are detected, additional tests are prescribed to check the liver. Confirm the presence and progression of hepatitis using PCR. High-quality PCR helps to choose the right dosage of medications.
Autoimmune Hepatitis Tests
A chronic inflammatory process in the liver, characterized by peripartal damage and the presence of autoantibodies to hepatocytes, is called autoimmune hepatitis. It is much less common than, for example, viral, but also dangerous.
The pathogenesis of the disease is based on a deficiency of immunoregulation. Due to the sharp decrease in T-lymphocytes, the number of IgG B cells increases sharply, which leads to the destruction of hepatocytes. There are 3 types of autoimmune hepatitis:
- I (anti-ANA) - more often diagnosed in people aged 10-20 years and over 50. It responds well to immunosuppressive therapy. If untreated, cirrhosis develops within 3 years.
- II (anti-LKM-I) - this form is more often diagnosed in childhood, more resistant to immunosuppression. After stopping the medication, relapses often occur.
- III (anti-SLA) - observed in people who have had the first type of illness.
Types of tests for the diagnosis of liver for autoimmune hepatitis:
- gamma globulin and IgG levels;
- biochemical analysis (AcT, Alt, bilirubin and others);
- markers of autoimmune hepatitis: SMA, ANA, LKM-1;
- liver biopsy.
What is fibrotest
Inflammatory processes in the liver cells, alcohol abuse, frequent use of antibiotics, and the presence of hepatitis lead to liver fibrosis. Violation of the morphogenesis of the liver tissue (replacing the parenchyma with connective) and bile ducts leads to liver failure.
To detect fibrosis, a fibrotest is performed. This analysis to check the liver is considered an analogue of a biopsy, to which there are a lot of contraindications. The test biomaterial for fibrotest is venous blood.
The essence of the study is the detection of specific biomarkers in the patient’s blood plasma, indicating the presence and degree of proliferation and scarring of the parenchymal tissue. The analysis also reveals fatty degeneration of the gland (steatosis). Interpretation of the results is carried out by the doctor who prescribed the examination.
Deciphering liver fibrotest:
- F0 - lack of signs of pathology;
- F1 - single septa are observed;
- F2 - portal fibrosis;
- F3 - revealed multiple portal-central septa;
- F4 - cirrhosis of the liver.
In addition to the alphanumeric, there is a color interpretation, according to which the degree of pathology is judged:
- “Green” - absence of a disease or latent stage of development;
- "Orange" - a moderate degree of fibrosis;
- "Red" - severe damage to the parenchyma.
Assessment of liver function
To assess the functioning of the gland, various functional tests are used:
- Bromosulfophthalein sample. The method allows you to explore the absorption and excretory function of an organ. the test is highly accurate and easy to conduct. A 5% solution of bromsulfatalein at the rate of 5 mg per kilogram of weight is injected into a vein. After 3 minutes, take readings and take for 100%. After 45 minutes, the dye residue is calculated. Normally, it is 5%. The use of this analysis for liver disease occurring without jaundice allows early detection of pathological changes in hepatocytes.
- Vaferverdinovy test is aimed at identifying small gland failure (hepatosuppressive syndrome). Vovaverdine solution is injected into a vein, after 3 minutes a measurement is taken, repeated after 20 minutes. Normally, the dye should remain no more than 4%. The substance may cause allergies and may also cause blood clots, therefore the test is not often used.
- Galactose test (Bauer). With the help of the study, violations of the breakdown of carbohydrates in the liver are revealed. A galactose solution (40%) is administered intravenously at the rate of 0.25 g per kg of body weight. Blood is taken after 5, 10 minutes and 2 hours after administration of the reagent. With liver diseases, galactose does not turn into dextrose.
- Quick-Pytel test. By testing, the antitoxic function of the gland is evaluated.The patient drinks a glass of coffee on an empty stomach and eats 50 g of crackers. After an hour, he drinks 30 ml of water with sodium benzoate dissolved in it (4 g). Immediately drinks another glass of plain water and passes control urine. Then every hour the patient gives up more urine. Hydrochloric acid is added to all portions and shaken thoroughly. After one hour, the precipitate is filtered and dried. The solids weight is multiplied by 0.68. A significant decrease in sediment (up to 80%) indicates toxic liver damage.
Conclusion
No one is safe from liver diseases. They are dangerous for their long asymptomatic course. The absence of unpleasant manifestations in the form of pain does not mean that the gland is healthy. To assess the condition of the body is possible only by the results of the diagnosis.
To know which blood counts indicate liver disease is not enough, it is important not to expose the organ to “danger”. Proper nutrition, refusal of alcohol, taking medications only under the supervision of a doctor, the use of contraceptives during sex will help protect the gland from pathologies.