Liver, how hard can it be?

Liver is an important digestive organ of human body, which consists of 25 billion hepatocytes with 50-1 million hepatic lobules. Each hepatic lobule forms the smallest functional unit of liver, which is responsible for the important functions of human body, such as digestion, absorption, synthesis, detoxification and excretion, etc. Liver cells are very fragile, and many factors can cause liver cell damage. Liver cells are very fragile, many factors, bacterial or viral infections, chemical poisons, drugs, alcohol, etc. can lead to liver cell damage, affecting liver function; of course, liver cells also have a strong regenerative ability, when a liver cell dies, its neighboring normal liver cells can quickly undergo mitosis to generate new liver cells. If the number and speed of hepatocyte regeneration can be consistent with hepatocyte necrosis, the structure of liver tissue can remain unchanged. However, if the speed and number of hepatocyte regeneration is not as fast as the speed and number of hepatocyte necrosis, the structure of liver tissue will be disturbed, and the necrotic part of hepatocytes will be occupied by fibroblasts to form fibrosis. If the liver is repeatedly inflamed and fibrotic, the fibrosis gradually spreads to several lobules, and the normal structure of the liver is obviously damaged, then cirrhosis is formed. Once cirrhosis is formed, the reserve function of the liver will be greatly reduced, and if it continues to develop, it will become dysfunctional, with serious complications such as splenomegaly, ascites, upper gastrointestinal hemorrhage and hepatic coma, which are also very difficult to treat. Blood tests can show that the albumin level has decreased and the globulin level has increased and exceeded the albumin level, forming the so-called “white/globulin ratio” inversion phenomenon, and ultrasound examination can find that there are “small nodules” formed in the liver, with a diameter of 0.5-1 cm. liver fibrosis is reversible, but it can be reversed with the development of the liver fibrosis. Fibrosis is reversible, but cirrhosis is irreversible. Therefore, to prevent cirrhosis from occurring, it is important to reduce the occurrence of liver fibrosis and prevent it from turning into cirrhosis. For this purpose, early and active intervention is necessary, of which the most important is etiologic treatment. Cirrhosis that occurs on the basis of chronic viral hepatitis (mainly hepatitis B and hepatitis C) we call hepatitis cirrhosis, which is the most common cause of cirrhosis in China. So as far as chronic hepatitis B and chronic hepatitis C are concerned, the key to treatment is antiviral. Chronic hepatitis B can choose α-interferon or nucleoside drug treatment: 1, α-interferon has “ordinary interferon” and “long-acting interferon”, the former is injected intramuscularly (or subcutaneously) every other day, the latter is injected once a week, and the course of treatment is 1 year. The main disadvantage of interferon is that it has obvious side effects. At the beginning of the treatment, there will be fever, headache, limb weakness and other flu-like symptoms, and with the prolongation of the treatment time, some patients will experience hair loss, weight loss, as well as a decline in white blood cells and platelets, etc., but most of the patients are able to adhere to the treatment. Interferon and have strict indications for use, autoimmune diseases, psychiatric patients should be used with caution or prohibited, the emergence of significant jaundice, ascites cirrhosis patients can not be used. 2, currently listed nucleoside analogues in our country have lamivudine, adefovir, tibivudine and entecavir and so on 4 kinds of indications are wider, easy to take orally, can take 1 tablet per day, there is no obvious side effects, the shortcomings of the treatment is a long course of treatment, at least 3 years. The disadvantage is that the treatment course is long, at least 3 years, and drug resistance may occur in the long term. Patients should consider which antiviral drug to choose according to various factors such as their condition and their own financial conditions, and it is better to follow the advice of experts. The only available option for antiviral treatment of chronic hepatitis C is alpha-interferon combined with ribavirin. Antiviral treatment for chronic viral hepatitis is a long process, and patients must recognize the importance, complexity and intractability of the treatment, strictly follow medical advice and persevere. At the same time as antiviral, it should also actively control liver inflammation, protect liver cells, and anti-hepatic fibrosis treatment. Generally speaking, as long as there is an elevation of transaminase, it indicates that there is hepatocellular damage, and even if there are no conscious symptoms, it should not be ignored. For treatment, some liver-protecting and enzyme-lowering drugs (e.g. glycopyrrolate amines, schizopyrrolate, silymarin, and polyene phosphatidylcholine, etc.) can be chosen. In terms of diet, alcohol must be strictly abstained from. Alcohol is a strong oxidizing agent, the liver cells have obvious toxic effects, drinking alcohol is bound to accelerate the occurrence and development of cirrhosis; alcohol is a catalyst for liver cancer, hepatitis patients are particularly sensitive to alcohol, surveys show that hepatitis patients do not pay attention to abstain from alcohol, the incidence of hepatocellular carcinoma will be substantially increased.