Method for examination of liver cirrhosis

        Common inspection items

        Liver function tests, blood pressure, glucagon loading test, liver test, test reflect the variation of the reflecting liver reserve function

Inspection method

laboratory examination

        1, blood routine: in hypersplenism, pancytopenia, leukopenia, often at 4 * 109/L (4000), platelet in more than 50 * 109/L (50000), most cases showed normal cell anemia, a few cases for large cell anemia.

        2, urine examination: when there is jaundice, urine bilirubin / urine bile positive.

        3, the ascites routine examination: ascites transudate, density 1.018, Lee was negative, the number of cells following 100/mm3, protein quantity is less than 25g/L.

        4, liver function test: liver function is very complex, a lot of clinical testing methods, but it is difficult to reflect the state of the whole function, a variety of laboratory results to be combined with clinical manifestations and other comprehensive analysis of the examination.

(1) the test of protein metabolism:

        Determination of plasma protein, albumin <30g/L below normal (40 ~ 50) g/L, >40g/L (normal globulin can be 20 ~ 30g/L), the reverse ratio of albumin and globulin, the ratio is generally 0.5 to 0.7, less than 1 (normal 1.3 to 2.5: 1).

        The test of plasma protein floc: cirrhosis abnormalities, can be more significant than normal precipitation occurred the patient serum and some mixed reagent, turbid or floc precipitation, called flocculation test positive, gamma globulin can lead to increased positive; 1 globulin and albumin, alpha beta globulin can inhibit this reaction floccalation, mainly reflect the degree of inflammation, does not reflect the degree of liver cell damage, in decompensated liver function, and flocculent turbidity test can be normal or slightly abnormal, and in decompensation period are not normal, the most sensitive (zntt below normal 12 units), cephalin flocculation times (normal below), thymol turbidity test was the most insensitive (below normal 6 units), has been rarely used.

        The protein electrophoresis: cirrhosis showed low serum albumin (normal 54% ~ 61%), alpha globulin increased (14% ~ 6% normal alpha, alpha 27% ~ 9%), little change in beta globulin (10% ~ 13%), gamma globulin often increased (normal 17% ~ 22%), various protein components of protein electrophoresis in addition, immunoglobulin, is synthesized by liver parenchymal cells, gamma globulin synthesized by reticuloendothelial cells, albumin was significantly lower, gamma globulin increased significantly, often reflect the chronic liver disease in nature, often have this kind of performance in a variety of liver cirrhosis, gamma globulin and albumin increased continuously, normal. In compensated cirrhosis, chronic liver disease in liver cirrhosis may have 1 alpha globulin decrease, beta globulin increased, often reflect the obstruction of bile duct.

The determination of blood ammonia: hepatic encephalopathy, blood ammonia can be increased, normal blood ammonia is 34 ~ 100 mol/L.

        (2) bilirubin metabolism test: liver function decompensated without jaundice, decompensated about more than half of patients with jaundice, there is active hepatitis or bile duct obstruction, one minute bilirubin and total bilirubin.

        (3) serum enzyme examination: liver cirrhosis, often ALT and AST (GPT, GOT) increased, reflecting the degree of liver cell damage, compensatory cirrhosis or not associated with active inflammation of the liver cirrhosis can not increase.

        Monoamine oxidase (MAO) associated with collagen metabolism, its activity can reflect the liver fibrosis degree and the process, such as mild liver fibrosis, its activity is roughly normal, if the liver has obvious fiber formation, increased the activity of MAO, more than about 80% cirrhosis increased, subacute severe hepatitis and chronic active hepatitis MAO also increased besides, liver diseases such as diabetes, hyperthyroidism, acromegaly, of scleroderma, heart failure, liver congestion and pediatric bone hyperplasia, Senile Arteriosclerosis can also be increased in patients with cirrhosis of the liver fibrosis process has been at rest or scar, because fiber activity is not obvious, MAO can be normal.

        Serum cholinesterase (ChE), decompensated liver cirrhosis often ChE activity decreased significantly, the decrease degree and serum albumin in parallel, the enzyme reflect the liver reserve ability, if the decrease indicates a poor prognosis.