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Liver Function Test. Normal Laboratory Values. Normal. Abnormal. 2 SD. normal values = mean ± 2SD of normal population. Liver Function Test.
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Normal Laboratory Values Normal Abnormal 2 SD normal values = mean ± 2SD of normal population
Liver Function Test interpretation must be performed within the context of the patient’s risk factors, symptoms, concomitant conditions, medications, and physical findings rarely provide specific Dx, but rather suggest a general category of liver disease differing laboratories differing normal values
classified in 3 groups synthetic function : albumin, PT hepatocyte injury : AST, ALT cholestasis : bilirubin, ALP, GGT PT, albumin, bilirubin-most common tests used as prognostic factors Liver Function Test
AST and ALT most frequent used markers of hepatocellular necrosis, but not correlate with eventual outcome decrease : recovery or poor prognosis poor prognosis : rapid fall with rising of bilirubin and PT
level of transminase elevation predominant AST elevation rate of transaminase declination AST, ALT
Peak values of transaminase activity occur between the 7th and l2th days; • activities then gradually decreaser,e aching normal levelsb ythe 3rd to 5th week if recovery is uneventful • Persistenceo f increased A LT for more than 6 months after an episode of acute hepatitis is used to diagnose chronic hepatitis
After AMI, increased AST activity appears in serum, as might be expected from the high AST concentration in heart muscle. AST activity also is increased in progressive muscu-
The ratio seems to clearly identify the liver-cell "necrotic type" condition (i'e'' slight enzyme increase concomitant with relatively high activities of mitochondrial enzymes), typical of alcoholic hepatitis
Several authors have described AST linked to immunoglobulins, or macro-AST The typical findings are a persistent increase of serum AST activity in an asymptomatic subiect, with the absence of any demonstrable pathology in organs rich in AS The increased AST activity might reflect decreased clearance of the abnormal complex from plasma. Macro-AST has no known clinical relevance