Love and be careful of the liver, pay attention not to get lost.
Old Li and his daughter-in-law came to the hospital, and I met them at the outpatient clinic.
Lao Li came to the hospital for further examination and treatment because of the physical examination and the discovery of hepatitis C.
We all know that this is one of the few viral hepatitis that can be completely cured at present.
By the way, I also checked the liver function of Lao Li's daughter-in-law. As a result, the old Li daughter-in-law did not have hepatitis C, but there was still abnormal liver function.
For Lao Li, I gave him a systematic examination of hepatitis C, which made it easier for him to apply for special antiviral treatment. The old daughter-in-law looked confused and kept asking, "How did I have liver disease?" Contagious? ”
In fact, the liver function of the old Li daughter-in-law is abnormal, mainly considering the fatty liver. The patient is 158cm tall and weighs 70kg, and for the sake of safety, I also ruled out hepatitis B and C virus infection for her, and only then did I give her a diagnosis.
Speaking of this, it is estimated that many people want to ask, what are the causes of liver disease? Are liver diseases contagious?
Let's start with viral hepatitis. What are viral hepatitis? How is it transmitted?
Common hepatophilic viruses and modes of transmission are as follows:
1) Viral hepatitis A
Infection is mainly through oral contamination of hands, water, food and utensils.
2) Viral hepatitis B
It is mainly transmitted through blood and body fluids (including semen, menstruation and vaginal secretions).
3) Viral hepatitis C
It is mainly transmitted through blood and blood products, followed by injectable drugs and unclean injections, and the frequency of sexual transmission, perinatal transmission and iatrogenic transmission is low.
4) D-viral hepatitis
Transmission is mainly through blood transfusions and the use of blood products, and daily contact is also possible, and perinatal transmission is rare.
5) Viral hepatitis E
The route of transmission is similar to that of viral hepatitis A.
In addition to hepatophilic viruses, there are also some non-hepatophilic virus infections in the clinic, which can also cause abnormal liver function.
For example, after infection with Epstein-Barr virus and cytomegalovirus (CMV), liver function can also be caused. Therefore, some patients will find abnormal liver function after catching a cold.
Of course, the liver is not lucky, in addition to viral causes, there are many other factors that can cause liver inflammation.
1) Non-alcoholic fatty liver
More common in obese patients. Patients with overweight, elevated blood lipids, imaging suggestive of fatty liver, exclusion of other causes of abnormal transaminases, and elevated transaminases are caused by steatohepatitis. It is because lipids are deposited in the liver and cause an inflammatory response. For such patients, weight loss and lipid reduction are the core treatments, and the drug is only adjunctive.
2) Alcoholic liver disease
It is a collective term for alcoholic fatty liver, alcoholic hepatitis, liver fibrosis and alcoholic cirrhosis caused by long-term excessive alcohol consumption. At present, alcoholic liver disease in mainland China is showing a rapidly growing trend. The concept of long-term alcohol consumption is: drinking alcohol for more than 5 years, male ethanol intake exceeds 40g per day, women more than 20g, or drink a lot of alcohol in 2 weeks, ethanol intake exceeds 80g per day. (The conversion formula for ethanol content is: g = amount of alcohol consumed (m1) × ethanol content (%) ×0.18). It can cause alcoholic liver disease.
3) Drug-induced liver injury
It can be induced by various prescription or over-the-counter chemical drugs, biological agents, traditional Chinese medicines, natural medicines, health care products, dietary supplements and their metabolites and even excipients. Be sure to consult whether the patient has taken drugs that are harmful to the liver, and if so, be sure to pay attention to the possibility of drug-induced hepatitis; a variety of drugs and chemical preparations can cause high transaminases, but can return to normal after stopping the drug.
4) Autoimmune liver disease
Autoimmune hepatitis with impaired hepatocytes as the main manifestation, primary bile cholangitis, primary sclerosing cholangitis and autoimmune cholangitis with bile duct epithelial cells as the main target cells, and IgG4-related cholangitis with increased IgG4 and plasma cell infiltration as the main target cells will all be manifested as elevated transaminases. In addition, systemic autoimmune diseases such as systemic lupus erythematosus, Sjogren's syndrome, and dermatomyositis can also affect the liver, manifesting as elevated transaminases.
5) Diseases of the biliary tract
For example, when cholecystitis and cholelithiasis are acutely attacked, in addition to being accompanied by fever, abdominal pain, nausea, vomiting, jaundice, etc., it can also cause elevated bilirubin and transaminases.
6) Heart disease
Acute myocardial infarction, myocarditis, and heart failure can cause elevated transaminases. Hepatic congestion formed by long-term right heart insufficiency can also elevate transaminases, leading to cardiogenic jaundice and even cardiogenic cirrhosis.
7) Metabolic diseases
Liver damage caused by hyperthyroidism, liver damage caused by diabetes, Wilson's disease caused by copper metabolism disorders, hemochromatosis caused by iron metabolism disorders, and fatty liver due to simple obesity or lipid metabolism disorders.
8) Other infectious diseases
In addition to the liver, other organ tissues in the body such as the heart, kidneys, lungs, brain, testicles, and muscles also contain this enzyme. Therefore, elevated transaminases in the blood can also be seen in patients with myocarditis, pyelonephritis, lobular pneumonia, tuberculosis, polymyositis, hyperthyroidism, acute sepsis, typhoid fever, cerebral flu, malaria, leptospirosis, influenza, measles, schistosomiasis, and squeeze syndrome.
9) Other causes: such as vascular malformations, etc., can also cause elevated transaminases.